Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several reports highlighted the risk of infection and disease in pregnant women and neonates. To assess the risk of clinical complications in pregnant women and neonates infected with SARS-CoV-2 carrying out a systematic review and meta-analysis of observational studies. Data sources: Search of the scientific evidence was performed using the engines PubMed and Scopus, including articles published from December 2019 to 15 April 2020. Study eligibility criteria: Only observational studies focused on the assessment of clinical outcomes associated with pregnancy in COVID-19 women were selected. Study appraisal and synthesis methods: The first screening was based on the assessment of titles and abstracts, followed by the evaluation of full-texts. Qualitative variables were summarized with frequencies, whereas quantitative variables with central and variability indicators depending on their parametric distribution. Forest plots were used to describe point estimates and in-between studies variability. Study quality assessment was performed. Results: Thirteen studies were selected. All of them were carried out in China. The mean (SD) age and gestational age of pregnant women were 30.3 (1.5) years and 35.9 (2.9) weeks, respectively. The mean (SD) duration from the first symptoms to the hospital admission and to labour were 5.5 (2.0) and 9.5 (8.7) days, respectively. Patients mainly complained of fever and cough (pooled (95 % CI) proportions were 76.0 % (57.0 %-90.0 %) and 38.0 (28.0 %-47.0 %), respectively). Several antibiotics, antivirals, and corticosteroids were prescribed in different combinations. The pooled prevalence of maternal complications and of caesarean section were 45.0 % (95 % CI: 24.0 %-67.0 %) and 88.0 % (95 %CI: 82.0 %-94.0 %). A proportion of pregnant women less than 20 % were admitted to ICU. The pooled proportion of preterm infants was 23.0 % (95 %CI: 11.0 %-39.0 %). The most frequent neonatal complications were pneumonia and respiratory distress syndrome. The pooled percentage of infected neonates was 6.0 % (95 %CI: 2.0 %-12.0 %). Conclusions: The present study suggests a high rate of maternal and neonatal complications in infected individuals. However, the current scientific evidence highlights a low risk of neonatal infection. Multicentre, cohort studies are needed to better elucidate the role of SARS-CoV-2 during pregnancy.

The high prevalence of metabolic disorders mainly related to insulin resistance and CVD risk factors in women with PCOS highlight the need for early lifestyle changes for reducing metabolic risks in these patients.

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Anisocytosis has been associated with the severity and prognosis of several acute and chronic diseases, as well as physiological conditions such as pregnancy. Anisocytosis is quantified by the red blood cell distribution width (RDW), expressed as the ratio, multiplied by 100, between the standard deviation (SD) of red blood cell volumes and the mean corpuscular volume, or as the SD of erythrocyte volumes (RDW-SD). The aim of the present review was to report the state of the art on the physiological values and the putative diagnostic and prognostic roles of RDW in complicated pregnancy. Literature research for articles published in the last ten years was conducted in Pubmed, Web of Science, ClinicalTrials.gov, and Scopus databases. Abstracts were independently screened by two investigators. If relevant, full articles were retrieved. References, in these articles, citing relevant reviews or original studies were also accessed to identify additional eligible studies. Any disagreement between the reviewers was resolved by a third investigator. A total of 28 studies were included in the review. These studies reported changes in RDW values during physiological pregnancy, and associations between the RDW and several pregnancy complications including anaemia, preeclampsia, gestational diabetes, and recurrent miscarriage. This review provides background information for establishing physiological and pathological RDW values in pregnancy for diagnostic and prognostic use in clinical practice.