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. 2020 Oct;151(1):7-16.
doi: 10.1002/ijgo.13329. Epub 2020 Aug 30.

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review

Ozlem Turan  1   2 , Amir Hakim  3   4 , Pradip Dashraath  5 , Wong Jing Lin Jeslyn  5 , Alison Wright  1 , Rezan Abdul-Kadir  1   2
Affiliations

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review

Ozlem Turan et al. Int J Gynaecol Obstet. 2020 Oct.

Abstract

Background: Pregnant women represent a potentially high-risk population in the COVID-19 pandemic.

Objective: To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID-19.

Search strategy: Relevant databases were searched up until May 29, 2020.

Selection criteria: Case series/reports of hospitalized pregnant women with laboratory-confirmed COVID-19.

Data collection and analysis: PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools.

Main results: Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory-confirmed SARS-CoV-2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D-dimer and interleukin-6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID-19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours.

Conclusions: Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D-dimer and interleukin-6 levels are predictive of poor pregnancy outcomes in COVID-19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.

Keywords: COVID-19; Intrauterine fetal demise; Maternal morbidity; Maternal mortality; Miscarriage; Neonatal morbidity; Neonatal mortality; Preterm birth.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart showing selection of studies for review. The reasons for excluding studies were (1) type of study (only case reports, case series, and retrospective cohort analyses were included); (2) language (non‐English and non‐Mandarin publications were excluded); (3) access to full text (abstract‐only publications were excluded); and (4) confirmation of SARS CoV‐2 infection (only laboratory‐confirmed cases were included).
See this image and copyright information in PMC

References

    1. Johns Hopkins . Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html. Accessed July 18, 2020.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG; Group P . Preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement. J Clin Epidemiol. 2009;62:1006–1012. - PubMed
    1. Zhang L, Jiang Y, Wei M, et al. Analysis of the pregnancy outcomes in pregnant women with COVID‐19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi. 2020;55:166–171. - PubMed
    1. Zhou R, Chen Y, Lin C, et al. Asymptomatic COVID‐19 in pregnant woman with typical chest CT manifestation: A case report. Chinese. J Perinat Med. 2020;23.
    1. Li Y, J W, Jingjing Z,, et al. Asymptomatic novel coronavirus infection in pregnant woman in the third trimester: A case report. Chin J Perinat Med. 2020.

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