The outcomes of COVID-19 in pregnant women and their neonates: a systematic review

Abstract

Background Coronavirus-2019 (COVID-19) is a global health concern, especially for high-risk individuals such as pregnant women. This systematic review evaluates the impact of COVID-19 on pregnant women and their newborns. Methods We did a systematic review to evaluate the effect of COVID-19 on pregnancy. A systematic search was performed of studies published on PubMed, Web of Science, Google Scholar, Embase, and preprint servers medRxiv and bioRxiv from 1 December 2019 to 1 Augus2020, with no restriction by language. The records were screened as per the protocol eligibility criteria. Findings This review includes 30 studies (China [n = 22], USA [n = 2], Italy [n = 2], UK [n = 1], Honduras [n = 1], Iran [n = 1], and Spain [n = 1]), which cumulatively evaluated 1200 pregnant women with clinically confirmed COVID-19 and their 1017 neonates. Of the 1200 pregnant women, 1009 had already delivered their infants, eight had medical abortions(979 singletons and 19 sets of twins) at the time of research, 189 were still pregnant, and two died of COVID19 before they were able to give birth. Caesarean sections were commonly performed for the pregnant women with COVID-19 (55%). Fever and cough were the most dominant symptoms among the women. Complications such as premature membrane rupture, preterm delivery, and foetal distress were observed. Small for gestational age and low birthweight were the most common adverse neonatal outcomes. The main laboratory findings among the pregnant women with COVID-19 were high C-reactive protein levels, lymphopenia, and leucocytosis. Chest computed tomography revealed abnormal viral lung changes in 44 percent of the women. Different treatments were given to the pregnant women compared to general COVID-19-infected patients. Seventy-eight (6.5%) critical cases were admitted to the intensive care unit. Twelve maternal deaths due to COVID-19 were reported. Thirty-three infants tested positive for SARS-CoV-2 infection by real-time RT-PCR. The route of transmission cannot be clearly determined. were clinically healthy and did not experience any complications. lymphopenia and thrombocytopenia were observed among infected infants with SARS-CoV-2. Conclusion The clinical features of pregnant women with COVID-19 were found to be similar to those of general infected patients. There is evidence of adverse pregnancy and neonatal outcomes caused by COVID-19. Keywords COVID-19, SARS-CoV-2, 2019‐nCoV, coronavirus-2019, pregnancy, pregnant, newborn, infant, neonatal.