June 18, 2020

Key Findings Could Change Standard of Care and Clinical Practice.

Bronx, NY (June 18, 2020) – Researchers at Montefiore Health System and Albert Einstein College of Medicine, in collaboration with four major New York City academic health centers, published the largest review to date of birth outcomes among women with SARS-COV-2, the novel coronavirus.

Published in Obstetrics & Gynecology on June 16, 2020, this unprecedented data reviewed 241 births to women with laboratory-confirmed SARS-CoV-2 who delivered between March 13 and April 12, 2020. Among the most compelling findings, when admitted to the hospital 61.4% of the 241 women included in this study were asymptomatic. Almost one-third of the asymptomatic women became symptomatic during their hospitalization. Nearly all newborns tested negative for SARS-CoV-2 immediately after birth (97.5%), and there were no maternal deaths.

“The good news is that these findings show that most pregnant women who contract this disease have good birth outcomes,” said Dr. Sharmila K. Makhija, M.B.A., chair and professor, Obstetrics & Gynecology and Women's Health, Montefiore Health System and Albert Einstein College of Medicine. “However, since we also discovered that asymptomatic infection is common among pregnant women, these results tell us that when the disease is prevalent in a given community, it’s crucial to test every woman in labor when she is admitted so that appropriate steps to control the spread of infection can be taken. Awareness of the positive test result upon admission allows us to change the patient’s care plan quickly if she develops more severe symptoms during labor.”

Other important findings in this study include:

  • Women with higher body mass index (greater than or equal to 30 kg/m2) were at risk to have more severe symptoms of COVID-19, a common observation found in all people and across most specialties in relation to outcomes for this disease.
  • Higher rates of preterm birth and cesarean birth were found among pregnant women who delivered with severe and critical COVID-19. Cesarean birth was the mode of delivery for 52.4% of women with severe and 91.7% with critical COVID-19. The singleton preterm birth rate among severe patients was 18.0% and 58.3% among critical COVID-19 patients; which is higher than the national average (10% in 2018) and reflects the fact that some women needed to be delivered based on how well the mother was able to breathe. *Preterm birth is defined as a baby born less than 37 weeks of gestation.

The women in this study represented the diversity of New York City: 43.9% Hispanic or Latinx; 30.3% White, non-Hispanic; 10.9% Black, non-Hispanic; and 14.9% who identified as Other.

“NYC data shows that the novel coronavirus is disproportionately affecting Black and Hispanic communities. As this pandemic continues to rapidly evolve, it is crucial to understand the impact of this disease on pregnant women, as well as how this impact may vary across different ethnicities,” said Dr. Rasha Khoury, MPH, Obstetrics & Gynecology and Women's Health, Montefiore Health System and Albert Einstein College of Medicine. “This new information will have a direct impact on helping us give the best possible care going forward.”

Montefiore clinical and research staff led this study, and continue to support ongoing research on the impact of social determinants of health on infection and disease severity, the question of mother to child transmission, and long-term maternal, pregnancy and newborn outcomes.

### 

About Montefiore Health System

Montefiore Health System is one of New York’s premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 11 hospitals, including the Children’s Hospital at Montefiore, Burke Rehabilitation Hospital and more than 200 outpatient ambulatory care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information please visit www.montefiore.org. Follow us on Twitter and view us on Facebook and YouTube.

 

About Albert Einstein College of Medicine

Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2019-20 academic year, Einstein is home to 724 M.D. students, 158 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,800 full-time faculty members located on the main campus and at its clinical affiliates. In 2019, Einstein received more than $178 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.