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Meta-Analysis
. 2021 Mar 5:2021:8870129.
doi: 10.1155/2021/8870129. eCollection 2021.

Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Leila Karimi  1 , Somayeh Makvandi  2 , Amir Vahedian-Azimi  3 , Thozhukat Sathyapalan  4 , Amirhossein Sahebkar  5   6   7
Affiliations
Meta-Analysis

Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Leila Karimi et al. J Pregnancy. .

Abstract

Background: Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19.

Methods: Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions.

Results: 117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term.

Conclusion: COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Figure 2
Figure 2
Forest plot of individual effect size for components and all comorbidities.
Figure 3
Figure 3
Funnel plot of log relative risks vs. the standard error for components and all comorbidities.
Figure 4
Figure 4
Forest plot of individual effect size for obesity.
Figure 5
Figure 5
Funnel plot of log relative risks vs. the standard error for obesity.
Figure 6
Figure 6
Forest plot of individual effect size for obesity after removing some studies.
Figure 7
Figure 7
Forest plot of individual effect size for obesity by subgroups.
Figure 8
Figure 8
Forest plot of individual effect size for diabetes.
Figure 9
Figure 9
Funnel plot of log relative risks vs. the standard error for diabetes.
Figure 10
Figure 10
Forest plot of individual effect size for obesity after removing some studies.
Figure 11
Figure 11
Forest plot of individual effect size for obesity by subgroups.
Figure 12
Figure 12
Forest plot of individual effect size for CVD.
Figure 13
Figure 13
Funnel plot of log relative risks vs. the standard error for CVD.
Figure 14
Figure 14
Forest plot of individual effect size for obesity after removing some studies.
Figure 15
Figure 15
Forest plot of individual effect size for obesity by subgroups.
Figure 16
Figure 16
Forest plot of individual effect size for delivery type.
Figure 17
Figure 17
Funnel plot of log relative risks vs. the standard error for delivery type.
See this image and copyright information in PMC

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