Clinical Manifestation and Maternal Complications and Neonatal outcomes in Pregnant Women with COVID 19: An Update a Systematic Review and Meta-analysis (preprint)

ABSTRACT

Background Existing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with coronavirus infection. outbreaks suggest that pregnant women and their fetuses are particularly susceptible to poor outcomes. However, there is little known about pregnancy related complications and co-morbidity in this group of women. Therefore, this, systematic review and meta-analysis performed in order to find out whether COVID-19 may cause different manifestations and outcomes in antepartum and postpartum period or not.Methods We searched databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid and CINHAL to retrieve all articles reporting the prevalence of maternal and neonatal complications, in addition clinical manifestations, in pregnant women with COVID 19 that published with English language from January to April 2020. Results 11 studies with total 177 pregnant women included in this systematic review.Results show that the pooled prevalence of neonatal mortality, lower birth weight, stillbirth, premature birth, and intrauterine fetal distress in women with COVID 19 were 4% (95% Cl 1 - 9%), 21% (95% Cl 11 – 31%), 2% (95% Cl 1 - 6%), 28% (95% Cl 12 - 44%), and 15% (95% Cl 4 - 26%); respectively. Also the pooled prevalence of fever, cough, diarrhea and dyspnea were 56% (95% Cl 30 - 83%), 30% (95% Cl 21 - 39%), 9% (95% Cl 2 - 16%), and 3% (95% Cl 1 - 6%) in the pregnant women with COVID-19.Conclusion According to this systematic review and meta-analysis, the pregnant women with COVID-19 with or without pneumonia, are at a higher risk of pre-eclampsia, preterm birth, miscarriage and cesarean delivery. Furthermore, the risk of LBW and intrauterine fetal distress seems increased in neonates.