Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review.
Int J Gynaecol Obstet
; 151(1): 7-16, 2020 Oct.
Article
in English
| MEDLINE | ID: covidwho-725708
ABSTRACT
BACKGROUND:
Pregnant women represent a potentially high-risk population in the COVID-19 pandemic.OBJECTIVE:
To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID-19. SEARCH STRATEGY Relevant databases were searched up until May 29, 2020. SELECTION CRITERIA Case series/reports of hospitalized pregnant women with laboratory-confirmed COVID-19. DATA COLLECTION ANDANALYSIS:
PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools. MAINRESULTS:
Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory-confirmed SARS-CoV-2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D-dimer and interleukin-6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID-19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours.CONCLUSIONS:
Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D-dimer and interleukin-6 levels are predictive of poor pregnancy outcomes in COVID-19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pregnancy Complications, Infectious
/
Pregnancy Outcome
/
Infectious Disease Transmission, Vertical
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Adult
/
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Language:
English
Journal:
Int J Gynaecol Obstet
Year:
2020
Document Type:
Article
Affiliation country:
Ijgo.13329
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