Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis
OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. STU...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Elsevier B.V.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373687/ https://www.ncbi.nlm.nih.gov/pubmed/32795828 http://dx.doi.org/10.1016/j.ejogrb.2020.07.034 |
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author | Dubey, Pallavi Reddy, Sireesha Y. Manuel, Sharron Dwivedi, Alok K. |
author_facet | Dubey, Pallavi Reddy, Sireesha Y. Manuel, Sharron Dwivedi, Alok K. |
author_sort | Dubey, Pallavi |
collection | PubMed |
description | OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. STUDY DESIGNS: PubMed search was performed of confirmed COVID-19 pregnant cases and related outcomes were ascertained prior to July 8, 2020, in this systematic review and meta-analysis. Studies reporting premature birth, low birth weight, COVID-19 infection in neonates, or mode of delivery status were included in the study. Two investigators independently performed searches, assessed quality of eligible studies as per the Cochrane handbook recommendations, extracted and reported data according to PRISMA guidelines. Pooled proportions of maternal and neonatal outcomes were estimated using meta-analyses for studies with varying sample sizes while a systematic review with descriptive data analysis was performed for case report studies. Maternal and neonatal outcomes included C-section, premature birth, low birth weight, adverse pregnancy events and COVID transmission in neonates. RESULTS: A total of 790 COVID-19 positive females and 548 neonates from 61 studies were analyzed. The rates of C-section, premature birth, low birth weight, and adverse pregnancy events were estimated as 72 %, 23 %, 7 %, and 27 % respectively. In the heterogeneity analysis, the rate of C-section was substantially higher in Chinese studies (91 %) compared to the US (40 %) or European (38 %) studies. The rates of preterm birth and adverse pregnancy events were also lowest in the US studies (12 %, 15 %) compared to Chinese (17 %, 21 %), and European studies (19 %, 19 %). In case reports, the rates of C-section, preterm birth, and low birth weight were estimated as 69 %, 56 %, and 35 %, respectively. Adverse pregnancy outcomes were associated with infection acquired at early gestational ages, more symptomatic presentation, myalgia symptom at presentation, and use of oxygen support therapy. CONCLUSIONS: Adverse pregnancy outcomes were prevalent in COVID-19 infected females and varied by location, type, and size of the studies. Regular screening and early detection of COVID-19 in pregnant women may provide more favorable outcomes. |
format | Online Article Text |
id | pubmed-7373687 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73736872020-07-22 Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis Dubey, Pallavi Reddy, Sireesha Y. Manuel, Sharron Dwivedi, Alok K. Eur J Obstet Gynecol Reprod Biol Review Article OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. STUDY DESIGNS: PubMed search was performed of confirmed COVID-19 pregnant cases and related outcomes were ascertained prior to July 8, 2020, in this systematic review and meta-analysis. Studies reporting premature birth, low birth weight, COVID-19 infection in neonates, or mode of delivery status were included in the study. Two investigators independently performed searches, assessed quality of eligible studies as per the Cochrane handbook recommendations, extracted and reported data according to PRISMA guidelines. Pooled proportions of maternal and neonatal outcomes were estimated using meta-analyses for studies with varying sample sizes while a systematic review with descriptive data analysis was performed for case report studies. Maternal and neonatal outcomes included C-section, premature birth, low birth weight, adverse pregnancy events and COVID transmission in neonates. RESULTS: A total of 790 COVID-19 positive females and 548 neonates from 61 studies were analyzed. The rates of C-section, premature birth, low birth weight, and adverse pregnancy events were estimated as 72 %, 23 %, 7 %, and 27 % respectively. In the heterogeneity analysis, the rate of C-section was substantially higher in Chinese studies (91 %) compared to the US (40 %) or European (38 %) studies. The rates of preterm birth and adverse pregnancy events were also lowest in the US studies (12 %, 15 %) compared to Chinese (17 %, 21 %), and European studies (19 %, 19 %). In case reports, the rates of C-section, preterm birth, and low birth weight were estimated as 69 %, 56 %, and 35 %, respectively. Adverse pregnancy outcomes were associated with infection acquired at early gestational ages, more symptomatic presentation, myalgia symptom at presentation, and use of oxygen support therapy. CONCLUSIONS: Adverse pregnancy outcomes were prevalent in COVID-19 infected females and varied by location, type, and size of the studies. Regular screening and early detection of COVID-19 in pregnant women may provide more favorable outcomes. Elsevier B.V. 2020-09 2020-07-22 /pmc/articles/PMC7373687/ /pubmed/32795828 http://dx.doi.org/10.1016/j.ejogrb.2020.07.034 Text en © 2020 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Review Article Dubey, Pallavi Reddy, Sireesha Y. Manuel, Sharron Dwivedi, Alok K. Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title | Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title_full | Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title_fullStr | Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title_full_unstemmed | Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title_short | Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis |
title_sort | maternal and neonatal characteristics and outcomes among covid-19 infected women: an updated systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373687/ https://www.ncbi.nlm.nih.gov/pubmed/32795828 http://dx.doi.org/10.1016/j.ejogrb.2020.07.034 |
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