A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome

Objective  To compare the clinical courses and outcomes of pregnant severe acute respiratory syndrome (SARS) patients and non-pregnant SARS patients.

Design  A case–control study.

Setting  Tertiary Hospital for Infectious Disease.

Sample  Ten pregnant and 40 non-pregnant female patients infected with SARS.

Methods  Clinical course and outcomes of pregnant SARS patients were compared with a group of non-pregnant SARS patient. Cases and controls were matched with respect to sex, age, timing of contracting SARS, health care workers status and underlying illness.

Main outcome measures  The incidence of intensive care unit admission, intubation, medical complications and death rate.

Results  Pregnancy had no discernible impact on clinical symptoms and presentation delay. Four out of the 10 pregnant patients, nevertheless, required endotracheal intubation and six were admitted to the intensive care unit (ICU), as compared with 12.5% intubation rate (P= 0.065) and 17.5% ICU admission rate (P= 0.012) in the non-pregnant group. More pregnant SARS patients developed renal failure (P= 0.006) and disseminated intravascular coagulopathy (P= 0.006), as compared with non-pregnant SARS group. There were three deaths in the pregnant group, whereas there was no death in the non-pregnant control group (P= 0.006).

Conclusion  Pregnant women with SARS experience a worse clinical course and poorer outcomes compared with non-pregnant women.