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Meta-Analysis
. 2022 Mar;156(3):394-405.
doi: 10.1002/ijgo.14015. Epub 2021 Nov 19.

Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: A comprehensive systematic review and meta-analysis

Kleyton S de Medeiros  1   2 , Ayane C A Sarmento  1 , Ana P F Costa  1 , Luíza T de A Macêdo  2 , Luís A S da Silva  2 , Cijara L de Freitas  1 , Ana C Z Simões  3 , Ana K Gonçalves  1   3
Affiliations
Meta-Analysis

Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: A comprehensive systematic review and meta-analysis

Kleyton S de Medeiros et al. Int J Gynaecol Obstet. 2022 Mar.

Abstract

Background: Pregnant patients are potentially vulnerable to COVID-19.

Objectives: To clarify the clinical features of COVID-19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients.

Search strategy: Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus.

Selection criteria: Articles published from December 2019 to February 2021.

Data collection and analysis: The reviewers extracted relevant data from the full-text. Data synthesis was performed using the R-4.1.0 Project for Statistical Computing for Windows. The meta-analysis of the included studies was carried out using the random-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis.

Results: A total of 70 studies included 10 047 pregnant women with COVID-19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17-0.34, I2 = 93%) and via cesarean delivery (42%, 95% CI 0.38-0.47, I2 = 92%). There were 108 maternal mortalities (2%, 95% CI 0.01-0.03, I2 = 54%) and 50 abortions (5%, 95% CI 0.03-0.09, I2 = 73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06-0.19, I2 = 91%), birth weight (15%, 95% CI 0.10-0.21, I2 = 76%), APGAR <7 (19%, 95% CI 0.12-0.28, I2 = 43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17-0.43, I2 = 90%), and fetal mortality (2%, 95% CI 0.01-0.03, I2 = 46%).

Conclusion: There was no evidence of severe acute respiratory syndrome coronavirus-2 in the placenta, breast milk, umbilical cord, and amniotic fluid of pregnant patients. PROSPERO registration number: CRD42020181519.

Keywords: COVID-19; coronavirus disease 2019; obstetrics; pregnancy.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram
FIGURE 2
FIGURE 2
Signs and symptoms of a pregnant woman with COVID‐19. Abbreviation: CI, confidence interval
FIGURE 3
FIGURE 3
Neonatal outcomes of pregnant women with COVID‐19. Abbreviation: CI, confidence interval; NICU, neonatal intensive care unit
See this image and copyright information in PMC

References

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