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

(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...

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Autores principales: Abou Ghayda, Ramy, Li, Han, Lee, Keum Hwa, Lee, Hee Won, Hong, Sung Hwi, Kwak, Moonsu, Lee, Minwoo, Kwon, Minjae, Koyanagi, Ai, Kronbichler, Andreas, Jacob, Louis, Smith, Lee, Shin, Jae Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692613/
https://www.ncbi.nlm.nih.gov/pubmed/33114779
http://dx.doi.org/10.3390/jcm9113441
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author Abou Ghayda, Ramy
Li, Han
Lee, Keum Hwa
Lee, Hee Won
Hong, Sung Hwi
Kwak, Moonsu
Lee, Minwoo
Kwon, Minjae
Koyanagi, Ai
Kronbichler, Andreas
Jacob, Louis
Smith, Lee
Shin, Jae Il
author_facet Abou Ghayda, Ramy
Li, Han
Lee, Keum Hwa
Lee, Hee Won
Hong, Sung Hwi
Kwak, Moonsu
Lee, Minwoo
Kwon, Minjae
Koyanagi, Ai
Kronbichler, Andreas
Jacob, Louis
Smith, Lee
Shin, Jae Il
author_sort Abou Ghayda, Ramy
collection PubMed
description (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.
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spelling pubmed-76926132020-11-28 COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases Abou Ghayda, Ramy Li, Han Lee, Keum Hwa Lee, Hee Won Hong, Sung Hwi Kwak, Moonsu Lee, Minwoo Kwon, Minjae Koyanagi, Ai Kronbichler, Andreas Jacob, Louis Smith, Lee Shin, Jae Il J Clin Med Article (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. MDPI 2020-10-26 /pmc/articles/PMC7692613/ /pubmed/33114779 http://dx.doi.org/10.3390/jcm9113441 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Abou Ghayda, Ramy
Li, Han
Lee, Keum Hwa
Lee, Hee Won
Hong, Sung Hwi
Kwak, Moonsu
Lee, Minwoo
Kwon, Minjae
Koyanagi, Ai
Kronbichler, Andreas
Jacob, Louis
Smith, Lee
Shin, Jae Il
COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title_full COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title_fullStr COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title_full_unstemmed COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title_short COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
title_sort covid-19 and adverse pregnancy outcome: a systematic review of 104 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692613/
https://www.ncbi.nlm.nih.gov/pubmed/33114779
http://dx.doi.org/10.3390/jcm9113441
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