publication . Article . 2020

COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

Ramy Abou Ghayda; Han Li; Keum Hwa Lee; Hee Won Lee; Sung Hwi Hong; Moonsu Kwak; Minwoo Lee; Minjae Kwon; Ai Koyanagi; Andreas Kronbichler; ...
Open Access English
  • Published: 26 Oct 2020 Journal: Journal of Clinical Medicine, volume 9, issue 11 (eissn: 2077-0383, Copyright policy)
  • Publisher: MDPI
  • Country: United Kingdom
Abstract
(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.
Persistent Identifiers
Fields of Science and Technology classification (FOS)
03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, 030219 obstetrics & reproductive medicine
Sustainable Development Goals (SDG)
3. Good health, 16. Peace & justice
Subjects
free text keywords: Article, coronavirus disease 2019, pregnancy, COVID-19, fetal death, neonatal outcomes, preterm birth, SARS-CoV-2, stillbirth, maternal morbidity, maternal mortality, neonatal morbidity, neonatal mortality, COVID-19, SARS-CoV-2, coronavirus disease 2019, fetal death, maternal morbidity, maternal mortality, neonatal morbidity, neonatal mortality, neonatal outcomes, pregnancy, preterm birth, stillbirth, General Engineering, Rupture of membranes, Neonatal infection, Medicine, business.industry, business, Fetal distress, medicine.disease, Abortion, Obstetrics, medicine.medical_specialty, Pregnancy, Systematic review, Sore throat, medicine.symptom, Standardized mortality ratio, lcsh:Medicine, lcsh:R
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