Pregnancy and breastfeeding during COVID-19 pandemic: A systematic review of published pregnancy cases

Abstract

26Background: The COVID-19 pandemic is an emerging concern regarding the potential 27 adverse effects during pregnancy. This study reviews knowledge on the impact of 28 COVID-19 on pregnancy and describes the outcome of published cases of pregnant 29 women diagnosed with Methods: Searches were conducted in PubMed® up to 8 April 2020, using PRISMA 31 standards, to identify original published studies describing pregnant women at any 32 gestational age diagnosed COVID-19. There were no date or language restrictions on the 33 search. All identified studies were included irrespective of assumptions on study quality. 34 Results: We identified 30 original studies reporting 212 cases of pregnant women with 35 COVID-19 (30 discharged while pregnant), 200 from China and 12 from other countries. 36The 182 published deliveries resulted in one stillbirth and 185 live births. Four women 37 with severe COVID-19 required admission to an intensive care unit but no cases of 38 maternal death were reported. There was one neonatal death. Preterm births occurred in 39 28.7% of cases, but it is unclear whether this was iatrogenic. All cases with amniotic fluid, 40 placenta, and/or cord blood analyzed for the SARS-CoV-2 virus were negative. Four 41 newborns were positive for SARS-CoV-2 and three newborns had high levels of IgM 42 antibodies. Breast milk samples from 13 mothers and described in seven studies showed 43 no evidence of SARS-CoV-2. 44 Conclusion: The evidence related to the effect of COVID-19 on pregnant women is still 45 limited. Pregnant women and newborns should be considered particularly vulnerable 46 populations regarding COVID-19 prevention and management strategies.47 48 Wuhan, China, 1 and can present from asymptomatic to a severe acute respiratory infection 55 requiring intensive care. 2, 3 The infection can occur at any age, but COVID-19 is 56 proportionally uncommon in children (<1% of the total cases). The infection fatality rate 57 is around 1% but much higher in older people or those with pre-existing medical 58 conditions (such as heart disease, diabetes, COPD). 2, 4 59Person-to-person transmission of COVID-19 is well established and can occur when an 60 infected person coughs, sneezes or speaks and scattered droplets are inhaled or reach the 61 mucous membranes of the mouth, nose or eyes of susceptible. COVID-19 can also be 62 transmitted through direct hand contact with surfaces or objects contaminated with 63 SARS-CoV-2 followed by contact with the mouth, nose or eyes. 2 64Pregnant women and newborns receive special attention and there is an emerging concern 65 with the potential risk of SARS-COV-2 vertical transmission (from mother to fetus) or 66 associated malformations, and contagion during delivery and breastfeeding; likewise, it 67 is important to determine the potential adverse effects of COVID-19 in pregnant women. 5-68 8 However, in general, the available information remains scarce. 312The authors are grateful to the health professionals who provided and confirmed the cases 313 of pregnant women ...

Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

“…This manuscript has been released as a preprint at MedRxiv Rodrigues et al (200). The authors acknowledge the contribution of Ana Alfredo, Anzhela Sorokina, and Pedro Pimenta to data extraction.…”

The Effectiveness of Audio-Visual Education on Lactation Management and Chocking in Mother with Baby in Pandemic Time Covid-19

“…Obstetricians must take action to safeguard perinatal mental health 3 . The ability to provide support and to protect our breastfeeding mothers becomes extremely difficult where the virus is rampant [4][5][6][7] Mother's milk is the best life fluid that is needed by babies. Mother's milk contains various substances that are important for the growth and development of babies and according to their needs, but not all mothers want to breastfeed their babies for various reasons, for example, fear of fat, busyness, saggy breasts, and so on, some mothers want to breastfeed their babies, but there are many obstacles, usually, breast milk does not want to come out or the production is not smooth 8 .…”

Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A systematic review

“…Current risk factors of placental abruption include smoking and trauma, suggesting an interplay of complex factors dependent on maternal lifestyle behaviours in addition to chorioamnionitis and decidual vascular lesion [ 86 ]. Rodrigues and colleagues also found one instance of placental abruption in their systematic review [ 87 ]; therefore, although not a regular occurrence, future monitoring of placental abruption may be encouraged. In another study, placental abnormalities such as placenta previa, placenta accrete, and placental abruption were also prevalent in 2% of pregnant women with COVID-19 [ 88 ].…”