| dc.description.abstract | Coronavirus disease 2019 (COVID-19) has become a global pandemic and may
adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal
characteristics and outcomes among COVID-19 infected women and determined heterogeneity in
the estimates and associated factors.
Study Designs: PubMed search was performed of confirmed COVID-19 pregnant cases and related
outcomes were ascertained prior to July 8, 2020, in this systematic review and meta-analysis.
Studies reporting premature birth, low birth weight, COVID-19 infection in neonates, or mode of
delivery status were included in the study. Two investigators independently performed searches,
assessed quality of eligible studies as per the Cochrane handbook recommendations, extracted and
reported data according to PRISMA guidelines. Pooled proportions of maternal and neonatal
outcomes were estimated using meta-analyses for studies with varying sample sizes while a
systematic review with descriptive data analysis was performed for case report studies. Maternal
and neonatal outcomes included C-section, premature birth, low birth weight, adverse pregnancy
events and COVID transmission in neonates. Results: A total of 790 COVID-19 positive females and 548 neonates from 61 studies were
analyzed. The rates of C-section, premature birth, low birth weight, and adverse pregnancy events
were estimated as 72%, 23%, 7%, and 27% respectively. In the heterogeneity analysis, the rate of
C-section was substantially higher in Chinese studies (91%) compared to the US (40%) or
European (38%) studies. The rates of preterm birth and adverse pregnancy events were also lowest
in the US studies (12%, 15%) compared to Chinese (17%, 21%), and European studies (19%,
19%). In case reports, the rates of C-section, preterm birth, and low birth weight were estimated
as 69%, 56%, and 35%, respectively. Adverse pregnancy outcomes were associated with infection
acquired at early gestational ages, more symptomatic presentation, myalgia symptom at
presentation, and use of oxygen support therapy.
Conclusions: Adverse pregnancy outcomes were prevalent in COVID-19 infected females and
varied by location, type, and size of the studies. Regular screening and early detection of COVID19 in pregnant women may provide more favorable outcomes. | |
