IMPACT OF SARS-COV-2 INFECTION TO RISK AND SEVERITY OF HYPERTENSION IN PREGNANCY AND ITS OUTCOME TO THE NEW BORN

ABSTRACT

Objective: To determine relationship of SARS-CoV-2 infection to the risk and severity of preeclampsia, as well as its impact on newborns. Design and method: We performed a systematic search in databases (PubMed, ScienceDirect, ProQuest, and Cochrane Library) for studies examining impact of SARS-CoV-2 infection on pregnancy. Included studies were evaluated for risk of bias based on the Newcastle Ottawa Score. A meta-analysis was conducted using the data extracted from each study. Review Manager (RevMan) 5.4 was utilized to compute the summary of odds ratios (OR), mean differences (MD), and 95% confidence intervals (CI) for the outcomes. Our outcomes of interest are preeclampsia, preeclampsia with severe features, eclampsia, fetal distress and still birth. The other outcomes are preterm birth (< 37 week), instrumental labor, sectio caesaria and birth defect. Results: We identified twenty two observational studies involving 1,025,048 pregnancy patients. Based on the analysis, SARS-CoV-2 infection in pregnancy significantly increased the risk of preeclampsia [OR 2.01(95% CI 1.59-2.53;p < 0.00001;I2 = 82%)], and the severity was based on the high prevalence of preeclampsia with severe features [OR 3.04(95% CI 1.19-7.78;p = 0.02;I2 = 91%)] and eclampsia [OR 17.73(95% CI 13.83-22.72;p < 0.00001;I2 = 0%)]. Poor outcome in newborns in terms of incidence of preterm birth [OR 1.65(95% CI 1.54- 1.76;p < 0.00001;I2 = 86%)], fetal distress [OR 19.18(95% CI 17.14-21.45;p < 0.00001;I2 = 99%)] and still birth [OR 2.12(95% CI 1.74-2.59;p < 0.00001;I2 = 0%)], were also significantly associated with SARS-CoV-2 infection. Conclusions: SARS-CoV-2 infection during pregnancy increases the risk and severity of preeclampsia and gives a poor outcome in newborn.