tetano
Editor, Senior Moderator
Int J Gynaecol Obstet
. 2021 Nov 11.
doi: 10.1002/ijgo.14015. Online ahead of print.
Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: A comprehensive systematic review and meta-analysis
Kleyton S de Medeiros[SUP] 1 2 [/SUP], Ayane C A Sarmento[SUP] 1 [/SUP], Ana P F Costa[SUP] 1 [/SUP], Luíza T de Araújo Macêdo[SUP] 2 [/SUP], Luís A S da Silva[SUP] 2 [/SUP], Cijara L de Freitas[SUP] 1 [/SUP], Ana C Zimmermann Simões[SUP] 3 [/SUP], Ana K Gonçalves[SUP] 1 3 [/SUP]
Affiliations
Abstract
Background: Pregnant patients are potentially vulnerable to COVID-19.
Objectives: To clarify the clinical features of COVID-19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients.
Search strategy: Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus.
Selection criteria: Articles published from December 2019 to February 2021.
Data collection and analysis: The reviewers extracted relevant data from the full-text. Data synthesis was performed using the R-4.1.0 Project for Statistical Computing for Windows. The meta-analysis of the included studies was carried out using the random-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis.
Results: A total of 70 studies included 10 047 pregnant women with COVID-19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17-0.34, I[SUP]2[/SUP] =93%) and via cesarean delivery (42%, 95% CI 0.38-0.47, I[SUP]2[/SUP] =92%). There were 108 maternal mortalities (2%, 95% CI 0.01-0.03, I[SUP]2[/SUP] =54%) and 50 abortions (5%, 95% CI 0.03-0.09, I[SUP]2[/SUP] =73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06-0.19, I[SUP]2[/SUP] =91%), birth weight (15%, 95% CI 0.10-0.21, I[SUP]2[/SUP] =76%), APGAR <7 (19%, 95% CI 0.12-0.28, I[SUP]2[/SUP] =43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17-0.43, I[SUP]2[/SUP] =90%), and fetal mortality (2%, 95% CI 0.01-0.03, I[SUP]2[/SUP] =46%).
Conclusion: There was no evidence of severe acute respiratory syndrome coronavirus-2 in the placenta, breast milk, umbilical cord, and amniotic fluid.
Keywords: COVID-19; coronavirus disease 2019; obstetrics; pregnancy.
. 2021 Nov 11.
doi: 10.1002/ijgo.14015. Online ahead of print.
Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: A comprehensive systematic review and meta-analysis
Kleyton S de Medeiros[SUP] 1 2 [/SUP], Ayane C A Sarmento[SUP] 1 [/SUP], Ana P F Costa[SUP] 1 [/SUP], Luíza T de Araújo Macêdo[SUP] 2 [/SUP], Luís A S da Silva[SUP] 2 [/SUP], Cijara L de Freitas[SUP] 1 [/SUP], Ana C Zimmermann Simões[SUP] 3 [/SUP], Ana K Gonçalves[SUP] 1 3 [/SUP]
Affiliations
- PMID: 34762735
- DOI: 10.1002/ijgo.14015
Abstract
Background: Pregnant patients are potentially vulnerable to COVID-19.
Objectives: To clarify the clinical features of COVID-19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients.
Search strategy: Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus.
Selection criteria: Articles published from December 2019 to February 2021.
Data collection and analysis: The reviewers extracted relevant data from the full-text. Data synthesis was performed using the R-4.1.0 Project for Statistical Computing for Windows. The meta-analysis of the included studies was carried out using the random-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis.
Results: A total of 70 studies included 10 047 pregnant women with COVID-19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17-0.34, I[SUP]2[/SUP] =93%) and via cesarean delivery (42%, 95% CI 0.38-0.47, I[SUP]2[/SUP] =92%). There were 108 maternal mortalities (2%, 95% CI 0.01-0.03, I[SUP]2[/SUP] =54%) and 50 abortions (5%, 95% CI 0.03-0.09, I[SUP]2[/SUP] =73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06-0.19, I[SUP]2[/SUP] =91%), birth weight (15%, 95% CI 0.10-0.21, I[SUP]2[/SUP] =76%), APGAR <7 (19%, 95% CI 0.12-0.28, I[SUP]2[/SUP] =43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17-0.43, I[SUP]2[/SUP] =90%), and fetal mortality (2%, 95% CI 0.01-0.03, I[SUP]2[/SUP] =46%).
Conclusion: There was no evidence of severe acute respiratory syndrome coronavirus-2 in the placenta, breast milk, umbilical cord, and amniotic fluid.
Keywords: COVID-19; coronavirus disease 2019; obstetrics; pregnancy.