Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

Abstract

Background: The recent COVID-19 outbreak in Wuhan, China, has quickly spread throughout the world. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19. Methods: PubMed, Web of Science, EMBASE and MEDLINE were searched from January 1, 2020, to April 16, 2020. Case reports and case series of pregnant women infected with SARS-CoV-2 were included. Two reviewers screened 366 studies and 14 studies were included. Four reviewers independently extracted the features from the studies. We used a random-effects model to analyse the incidence (P) and 95% confidence interval (95% CI). Heterogeneity was assessed using the I 2 statistic. Results: The meta-analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95% CI, 0.49-0.93), caesarean section (65%; 95% CI, 0.42-0.87), fever (51%; 95% CI, 0.35-0.67), lymphopenia (49%; 95% CI, 0.29-0.70), coexisting disorders (33%; 95% CI, 0.21-0.44), cough (31%; 95% CI, 0.23-0.39), fetal distress (29%; 95% CI, 0.08-0.49), preterm labor (23%; 95% CI, 0.14-0.32), and severe case or death (12%; 95% CI, 0.03-0.20). The subgroup analysis showed that compared with non-pregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women, 51%; non-pregnant patients, 91%; P < 0.00001) and cough (pregnant women, 31%; non-pregnant patients, 67%; P < 0.0001). Conclusions: The incidences of fever, cough and positive CT findings in pregnant women with COVID-19 are less than those in the normal population with COVID-19, but the rate of preterm labor is higher among pregnant with COVID-19 than among normal pregnant women. There is currently no evidence that COVID-19 can spread through vertical transmission.

Clinical Characteristics and Neonatal Outcomes of Pregnant Patients With COVID-19: A Systematic Review

“…Since, several articles have reported that the possibilities of vertical transmission (37,38), highlighting the importance of long-follow up of newborns (39). To clarify the vertical transmission and neonatal outcomes due to SARS-CoV-2 infection; we further compared our findings with other recently published systematic review and meta-analyses (38,(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Raschetti et al (38) evaluated neonatal outcomes from 74 published articles in where 30% of neonates were reported in the possible vertical transmission and 70% were from environmental sources ( Table 4).…”

Management of gestational diabetes in women with a concurrent severe acute respiratory syndrome coronavirus 2 infection, experience of a single center in Northern Italy

“…We expect to increase our study sample in the following months and thus provide further results. The main strength of this study is that it was conducted in one of the six reference centres for the treatment of COVID-19 in women in Lombardy, the first region to be affected by the disease in Europe and one of the areas with the highest diffusion rate of infection [1][2][3][4][5][6][7][8][9][10].…”

Management of Pregnancy during the COVID‐19 Pandemic

“…Based on recent studies, the most common symptoms of pregnant women with COVID‐19 were fever and cough. [ 8 ] Pregnant women with these symptoms or with a history of contact with suspected or confirmed cases should visit fever clinics to receive tests for COVID‐19.…”

“…[ 17 ] A meta‐analysis included 236 pregnant women with COVID‐19 demonstrated that 71% patients had positive CT finding. [ 8 ] Chen et al. have found 88 of the 111 pregnant women in Wuhan (79%) who underwent chest CT had infiltrates in both lungs.…”