Pregnancies and SARS-CoV-2 infections in Germany – CRONOS register at UKSH and UK Dresden delivers initial results
11.11.2020 13:10
A corona infection can affect anyone, even during pregnancy. Scientists from the research network of the German Society for Perinatal Medicine (DGPM) are investigating what consequences this has for mother and child with the project “COVID-19 Related Obstetric and Neonatal Outcome Study in Germany” (CRONOS). The study brings together expertise in obstetrics and neonatology in more than 120 German clinics and is led by the two study leaders PD Dr. Ulrich Pecks, Head of the Obstetrics Department at the University Hospital Schleswig-Holstein on the Kiel Campus together with Prof. Dr. Mario Rüdiger, director of the Center for Feto-Neonatal Health at the University Hospital Dresden coordinated.
The scientists have now published the first results from CRONOS in the “Deutsches Ärzteblatt”. Accordingly, a total of 247 pregnant women who tested positive for SARS-CoV-2 were reported from 65 clinics by October 1, 2020.
The obstetrician PD Dr. Pecks comments that, fortunately, most pregnant women have a favorable outcome. Nevertheless, the illness should be taken seriously. 14 women received intensive care. “COVID-19 poses a challenge, especially during pregnancy, as treatment options are limited,” said Dr. Pecks. In the meantime, 185, or three quarters, of the pregnant women have given birth; most naturally; 75 women (41 percent) were delivered by cesarean section. “This means that a cesarean section was carried out more frequently in the group examined compared to the German average in previous years, but less frequently compared to pregnant women in many other countries,” summarizes the obstetrician.
“SARS-CoV-2 has an impact on newborns, particularly through more frequent premature births,” explains Prof. Mario Rüdiger. In the CRONOS registry, 25 children (almost 14 percent) were born prematurely and before the 38th week of pregnancy. However, only around two percent of newborns tested positive for SARS-Cov-2. And in most cases, this infection of the newborn is accompanied by only minimal symptoms of the disease. “International data also shows a similar magnitude. These are relatively reassuring numbers. It is important for mothers to be careful not to infect their newborn after the birth,” says Prof. Rüdiger.
Even during the pregnancy itself, over 36 percent of pregnant women reported being completely symptom-free. When women experienced symptoms, they included a cough (37.7 percent) or a general feeling of illness with chills (33.6 percent). Increased fatigue and tiredness were reported in 27.5 percent of cases and one in four of those affected noticed taste and smell disorders. Nausea or dizziness were rare.
“This central study on the consequences of a Sars-CoV2 infection during pregnancy fortunately shows predominantly mild courses without serious consequences for mother and child,” explains Prof. Dr. Joachim Thiery, Dean of the Medical Faculty at Kiel University and board member of the UKSH. “This study also impressively demonstrates how professionally the clinics across Germany are working together during the pandemic and how quickly important results can be brought together and published by university medicine.” Prof. Thiery hopes that this exemplary network will be maintained even after the pandemic.
“With studies like these, we are getting better and better at understanding the SARS-CoV-2 virus and also developing targeted measures for very specific patient groups,” explains Prof. Dr. Heinz Reichmann, Dean of the Medical Faculty at TU Dresden. It is therefore important to continue recording in the current situation, as this is the only way to check the transferability of international data to German conditions and to make appropriately adapted recommendations for medical care.
The results found for Germany on the impact of a SARS-CoV-2 infection during pregnancy are consistent with data recently published by the Center for Disease Control and Prevention (CDC). The CDC evaluated health data from Americans who tested positive for the coronavirus and had symptoms between January 22 and October 3, 2020; so that they were ill with Covid-19. The result: “Although the absolute risk of serious illness in women is low, there is an increased risk of severe Covid-19 in pregnant women compared to non-pregnant women of the same age,” says the study.
A final assessment of the effects of SARS-CoV-2 on pregnant women and newborns is not yet possible due to the currently low number of cases in Germany with regard to risk factors for severe maternal disease and child infections. “It is therefore absolutely necessary that we continue to run the German CRONOS register together with our colleagues from the DGPM research network, even if the financing has not yet been clarified,” say Prof. Rüdiger and Dr. Pecks agreed. The DGPM regularly publishes current data from the CRONOS register, in which 130 clinics now participate and care for around a quarter of all births in Germany, on its website (https://www.dgpm-online.org/gesellschaft/covid-19/).
The study was published in the Ärzteblatt under DOI 10.3238/arztebl.2020.0841 (Dtsch Ärztebl Int 2020; 117: 841-2; ONLINE first).