OUTCOMES OF COVID-19 DURING PREGNANCY: A SYSTEMATIC REVIEW
Objective: This paper presents specific pregnancy outcomes of COVID-19 during pregnancy, based on the literature available until August 2020. Methods: A systematic review was conducted in PubMed, Scopus, Google Scholar, Springer, Science Direct, and the EMBASE database of publications regarding coronavirus disease (COVID-19) following the PRISMA checklist. The search terms used include: “pregnancy”; “pregnant”; “neonatal”; “neonate”; “COVID-19”; “coronavirus disease 2019” “pregnancy”, “pregnant”, “neonatal” and “neonate”. All studies exploring the maternal and fetal outcomes among pregnant women with COVID-19 were considered for this review. Results: A total of 11 case reports on 17 pregnant women and 12 retrospective reviews of the medical records of 795 pregnant women meeting the inclusion criteria were included in the review. Of 362 deliveries, 59.3% involved caesarean sections [CS] while 40.6% were vaginal deliveries. Of the 362 deliveries, 22.37% were preterm. Of 51 neonates, 20% were found to have low birth weight and one tested positive for SARS-CoV-2. A total of nine neonatal deaths were reported, which were not associated with the viral infection, and 15 neonates were found to be COVID-19 positive, although no indication of vertical transmission of infection was established. Conclusions: Pregnancy does not increase the risk of COVID-19 and prospective mothers should follow the same recommendations as applicable to the general population, to limit the transmission of COVID-19. Information compiled in this systematic review of COVID-19-related pregnancy outcomes may help in planning the best care in future.
Keywords:COVID-19, Pregnancy Outcome, Maternal Outcome, Foetal Outcome
Alzamora, M.C., Paredes, T., Caceres, D., Webb, C.M., Valdez, L.M. & La Rosa, M., 2020. Severe COVID-19 during pregnancy and possible vertical transmission. American Journal of Perinatology, 37(8), p.861.
Antoun, L., El Taweel, N., Ahmed, I., Patni, S. & Honest, H., 2020. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 252, pp.559-562.
Bouaziz, J., Even, M., Isnard-Bogillot, F., Vesale, E., Nikpayam, M., Mihalache, A., Krief, D., Frydman, R. & Ayoubi, J.M. (2020). COVID-19 in pregnancy: What do we really know?. F1000Research, 9(362), p.362.
Cao, D., Yin, H., Chen, J., Tang, F., Peng, M., Li, R., Xie, H., Wei, X., Zhao, Y. & Sun, G., 2020. Clinical analysis of ten pregnant women with COVID-19 in Wuhan, China: A retrospective study. International Journal of Infectious Diseases. 95: pp294-300.
Capobianco, G., Saderi, L., Aliberti, S., Mondoni, M., Piana, A., Dessole, F., Dessole, M., Cherchi, P.L., Dessole, S. & Sotgiu, G. (2020). COVID-19 in pregnant women: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 252, pp 543-558.
Cevallos, M., Egger, M. & Moher, D. (2014). STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). Guidelines for Reporting Health Research: a User's Manual, pp.169-79.
Chen, H., Guo, J., Wang, C., Luo, F., Yu, X., Zhang, W., Li, J., Zhao, D., Xu, D., Gong, Q. & Liao, J. (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet, 395(10226), pp 809-815.
Dashraath, P., Jeslyn, W.J.L., Karen, L.M.X., Min, L.L., Sarah, L., Biswas, A., Choolani, M.A., Mattar, C. & Lin, S.L. (2020). Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. American Journal of Obstetrics and Gynecology.222(6) pp 521-531.
Dong, L., Tian, J., He, S., Zhu, C., Wang, J., Liu, C. & Yang, J., 2020. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. Jama, 323(18), pp.1846-1848.
Dubey, P., Reddy, S., Manuel, S. & Dwivedi, A.K., 2020. Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology.252; pp 490-501.
Ferrazzi, E., Frigerio, L., Savasi, V., Vergani, P., Prefumo, F., Barresi, S., Bianchi, S., Ciriello, E., Facchinetti, F., Gervasi, M.T. & Iurlaro, E., 2020. Vaginal delivery in SARS‐CoV‐2‐infected pregnant women in Northern Italy: a retrospective analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 127: 1116– 1121.
Gagnier, J.J., Kienle, G., Altman, D.G., Moher, D., Sox, H., Riley, D. & CARE Group (2013). The CARE guidelines: consensus-based clinical case reporting guideline development. Journal of Medical Case Reports, 7(1), p.223.
Govind, A., Essien, S., Karthikeyan, A., Fakokunde, A., Janga, D., Yoong, W. & Nakhosteen, A., 2020. Re: Novel Coronavirus COVID-19 in late pregnancy: Outcomes of first nine cases in an inner-city London hospital. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 251: 272–274.
Hansen, J.N., Hine, J. & Strout, T.D. (2020). COVID-19 and preeclampsia with severe features at 34-weeks gestation. The American Journal of Emergency Medicine, 39, pp 252-e3.
Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian SE, Pooransari P, Ghotbizadeh F, Aalipour S, Soleimani Z, Naemi M, Molaei B, Ahangari R, Salehi M, Oskoei AD, Pirozan P, Darkhaneh RF, Laki MG, Farani AK, Atrak S, Miri MM, Kouchek M, Shojaei S, Hadavand F, Keikha F, Hosseini MS, Borna S, Ariana S, Shariat M, Fatemi A, Nouri B, Nekooghadam SM. & Aagaard K. Maternal death due to COVID-19. American Journal of Obstetrics and Gynecology, 223(1), 109.e16.
Jordan, R.E., Adab, P. & Cheng, K.K. (2020). Covid-19: risk factors for severe disease and death. BMJ, 368:m1198
Kayem, G., Lecarpentier, E., Deruelle, P., Bretelle, F., Azria, E., Blanc, J., Bohec, C., Bornes, M., Ceccaldi, P.F., Chalet, Y. & Chauleur, C., 2020. A snapshot of the Covid-19 pandemic among pregnant women in France. Journal of Gynecology Obstetrics and Human Reproduction, 49(7), p.101826.
Khan, S., Peng, L., Siddique, R., Nabi, G., Xue, M., Liu, J. & Han, G., 2020. Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infection Control & Hospital Epidemiology, 41(6), pp.748-750.
Kolkova, Z., Bjurström, M.F., Länsberg, J.K., Svedas, E., Hamer, M.A., Hansson, S.R., Herbst, A. & Zaigham, M., 2020. Obstetric and intensive-care strategies in a high-risk pregnancy with critical respiratory failure due to COVID-19: A case report. Case Reports in Women's Health, 27, p.e00240.
Koumoutsea, E.V., Vivanti, A.J., Shehata, N., Benachi, A., Le Gouez, A., Desconclois, C., Whittle, W., Snelgrove, J. & Malinowski, A.K. (2020). COVID‐19 and acute coagulopathy in pregnancy. Journal of Thrombosis and Haemostasis, 18, pp 1648– 1652.
Lipsitch, M., Swerdlow, D.L. & Finelli, L. (2020). Defining the epidemiology of Covid-19—studies needed. New England Journal of Medicine, 382(13), pp 1194-1196.
Liu, D., Li, L., Wu, X., Zheng, D., Wang, J., Yang, L. & Zheng, C. (2020). Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. American Journal of Roentgenology, 215(1), pp 1-6.
Liu, W., Wang, Q., Zhang, Q., Chen, L., Chen, J., Zhang, B., Lu, Y., Wang, S., Xia, L., Huang, L. & Wang, K. (2020). Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprints 2020, 2020020373.
Moher D, Liberati A, Tetzlaff J. & Altman DG. The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, 6(7).
Nie, R., Wang, S.S., Yang, Q., Fan, C.F., Liu, Y.L., He, W.C., Jiang, M., Liu, C.C., Zeng, W.J., Wu, J.L. & Oktay, K. (2020). Clinical features and the maternal and neonatal outcomes of pregnant women with coronavirus disease 2019. MedRxiv.
Panahi, L., Amiri, M. & Pouy, S. (2020). Risks of novel coronavirus disease (COVID-19) in pregnancy; a narrative review. Archives of Academic Emergency Eedicine, 8(1), e34.
Qiao, J. (2020). What are the risks of COVID-19 infection in pregnant women? The Lancet, 395(10226), pp 760-762.
Rasmussen, S.A., Smulian, J.C., Lednicky, J.A., Wen, T.S. & Jamieson, D.J. (2020). Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology, 222(5), pp 415-426
Romero, D.G., Pérez, J.O., Bautista, L.G. & Santana-Cabrera, L. (2020). Pregnancy and perinatal outcome of a woman with COVID-19 infection. Revista Clinica Espanola, 220(8), pp 533–534.
Schwartz, D.A. (2020). An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Archives of Pathology & Laboratory Medicine, 144(7), pp 799-805.
Tutiya, C.T., Siaulys, M.M., Kondo, M.M., Miglioli-Galvão, L., Galvão, E.C., Pinheiro, C.C., Torloni, M.R. & de Mello, F.B. (2020). Possible formation of pulmonary microthrombi in the early puerperium of pregnant women critically ill with COVID-19: Two case reports. Case Reports in Women's Health, 27, p e00237.
Walczak, A., Wilks, K., Shakhovskoy, R., Baird, T., Schlebusch, S., Taylor, C., Reid, D. & Choong, K. (2020). COVID-19 in a complex obstetric patient with cystic fibrosis. Infection, Disease & Health, 25(4), pp 239-241.
Xu, L., Yang, Q., Shi, H., Lei, S., Liu, X., Zhu, Y., Wu, Q., Ding, X., Tian, Y., Hu, Q. & Chen, F. (2020). Clinical presentations and outcomes of SARS-CoV-2 infected pneumonia in pregnant women and health status of their neonates. Science Bulletin, 65(18), pp 1537–1542.
Yu, N., Li, W., Kang, Q., Xiong, Z., Wang, S., Lin, X., Liu, Y., Xiao, J., Liu, H., Deng, D. & Chen, S. (2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. The Lancet Infectious Diseases, 20(5), pp 559-564
Yu, Y., Fan, C., Bian, J. & Shen, Y. (2020). Severe COVID‐19 in a pregnant patient admitted to hospital in Wuhan. International Journal of Gynecology & Obstetrics, 150, pp 262-263
Zaigham, M. & Andersson, O. (2020). Maternal and perinatal outcomes with COVID‐19: A systematic review of 108 pregnancies. Acta Obstetricia et Gynecologica Scandinavica, 99(7), pp 823– 829.
Zambrano, L.I., Fuentes-Barahona, I.C., Bejarano-Torres, D.A., Bustillo, C., Gonzales, G., Vallecillo-Chinchilla, G., Sanchez-Martínez, F.E., Valle-Reconco, J.A., Sierra, M., Bonilla-Aldana, D.K. & Cardona-Ospina, J.A. (2020). A pregnant woman with COVID-19 in Central America. Travel Medicine and Infectious Disease, 36, pp101639.
Zeng, Y., Lin, L., Yan, Q., Wei, W., Yang, B.X., Huang, R., He, F. & Chen, D. (2020). Update on clinical outcomes of women with COVID‐19 during pregnancy. International Journal of Gynecology & Obstetrics, 150(2), pp 264-266.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X. & Guan, L. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229), pp 1054-1062.
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