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Review
. 2024 Feb 16;16(2):e54306.
doi: 10.7759/cureus.54306. eCollection 2024 Feb.

Perinatal Outcomes of Newborns of COVID-19-Infected Pregnant Women: An Updated Systematic Review and Meta-Analysis

Khaled El-Atawi  1 , Muzafar Gani Abdul Wahab  2 , Yasser Elsayed  3 , Maysa Saleh  4
Affiliations
Review

Perinatal Outcomes of Newborns of COVID-19-Infected Pregnant Women: An Updated Systematic Review and Meta-Analysis

Khaled El-Atawi et al. Cureus. .

Abstract

In this systematic review and meta-analysis, we aimed to review the characteristics and outcomes of the newborns of Coronavirus disease 2019 (COVID-19) infected pregnant women. We conducted an online bibliographic search using the following electronic databases: MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Central. Studies were deemed eligible if they recruited newborns from mothers with confirmed COVID-19 and reported the perinatal outcomes of neonatal COVID-19 cases. A total of 20 studies were included. Neonates born to mothers with positive COVID-19 results have been shown to have significantly lower birth weights (mean difference, MD = -48.54 g, p = 0.04), increased risks of fetal distress (odds ratio, OR = 1.76, p < 0.00001), respiratory distress (OR = 1.96, p = 0.006), premature birth (OR = 2.08, p < 0.00001), neonatal death (OR = 2.20, p = 0.004), and a lower 5-minute Apgar score (OR = 1.44, p = 0.02). Additionally, they were more likely to be admitted to the neonatal intensive care unit (NICU) (OR = 2.25, p = 0.007) and test positive for COVID-19 themselves (OR = 9.88, p = 0.03). However, other parameters, such as risks for malformations, mechanical ventilation, hypoglycemia, and sepsis, appeared to be comparable between the two groups. Maternal infection with COVID-19 during pregnancy is associated with several neonatal outcomes, some of which are adverse and others that do not show significant deviation from norms. While our meta-analysis clearly illustrates heightened risks associated with premature birth, reduced neonatal weight, and other challenges, it also emphasizes that not all neonatal outcomes can be directly attributed to maternal SARS-CoV-2 infection.

Keywords: covid-19; epidemic; newborn; perinatal outcomes; vertical transmission.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flow diagram.
PRISMA: Preferred reporting items for systematic review and meta-analysis.
Figure 2
Figure 2. a) Forest plot of neonatal weight, b) Sensitivity analysis of neonatal weight.
Figure 3
Figure 3. a) Funnel plot of neonatal weight, b) Funnel plot of NICU admission, c) Funnel plot of neonatal death, d) Funnel plot of Apgar 5 min (<7).
Figure 4
Figure 4. a) Forest plot of fetal distress, b) Respiratory distress, c) Premature death.
Figure 5
Figure 5. a) Forest plot of NICU admission, b) Sensitivity analysis of NICU admission.
Figure 6
Figure 6. a) Forest plot of neonatal death, b) Forest plot of stillbirth, c) Forest plot of Apgar score <7.
Figure 7
Figure 7. a) Forest plot of gestational age, b) Sensitivity analysis of gestational age.
Figure 8
Figure 8. a) Forest plot of malformation, b) Forest plot of hypoglycemia, c) Forest plot of sepsis.
Figure 9
Figure 9. a) Forest plot of mechanical ventilation, b) Forest plot of CPAP, c) Forest plot of oxygen therapy.
CPAP: Continuous positive airway pressure.
See this image and copyright information in PMC

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