COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission.
Aust N Z J Obstet Gynaecol
; 60(5): 640-659, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-703591
ABSTRACT
BACKGROUND:
Since its emergence in December 2019, COVID-19 has spread to over 210 countries, with an estimated mortality rate of 3-4%. Little is understood about its effects during pregnancy.AIMS:
To describe the current understanding of COVID-19 illness in pregnant women, to describe obstetric outcomes and to identify gaps in the existing knowledge.METHODS:
Medline Ovid, EMBASE, World Health Organization COVID-19 research database and Cochrane COVID-19 in pregnancy spreadsheet were accessed on 18/4, 18/5 and 23/5 2020. Articles were screened via Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following were excluded reviews, opinion pieces, guidelines, articles pertaining solely to other viruses, single case reports.RESULTS:
Sixty articles were included in this review. Some pregnant participants may have been included in multiple publications, as admission dates overlap for reports from the same hospital. However, a total of 1287 confirmed SARS-CoV-2 positive pregnant cases are reported. Where universal testing was undertaken, asymptomatic infection occurred in 43.5-92% of cases. In the cohort studies, severe and critical COVID-19 illness rates approximated those of the non-pregnant population. Eight maternal deaths, six neonatal deaths, seven stillbirths and five miscarriages were reported. Nineteen neonates were SARS-CoV-2 positive, confirmed by reverse transcription polymerase chain reaction of nasopharyngeal swabs. [Correction added on 2 September 2020, after first online publication the number of neonates indicated in the preceding sentence has been corrected from 'Thirteen' to 'Nineteen'.]CONCLUSIONS:
Where universal screening was conducted, SARS-CoV-2 infection in pregnancy was often asymptomatic. Severe and critical disease rates approximate those in the general population. Vertical transmission is possible; however, it is unclear whether SARS-CoV-2 positive neonates were infected in utero, intrapartum or postpartum. Future work should assess risks of congenital syndromes and adverse perinatal outcomes where infection occurs in early and mid-pregnancy.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pregnancy Complications, Infectious
/
Infant Mortality
/
Coronavirus Infections
/
Clinical Laboratory Techniques
/
Pandemics
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Adult
/
Female
/
Humans
/
Infant
/
Infant, Newborn
/
Pregnancy
/
Young adult
Country/Region as subject:
Oceania
Language:
English
Journal:
Aust N Z J Obstet Gynaecol
Year:
2020
Document Type:
Article
Affiliation country:
Ajo.13204
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