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COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Prognosis Elshafeey F, Magdi R, Hindi N, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020 Apr 24. doi: 10.1002/ijgo.13182.
Abstract

BACKGROUND: Clinical presentation and outcomes of COVID-19 infection during pregnancy remain limited and fragmented.

OBJECTIVES: To summarize the existing literature on COVID-19 infection during pregnancy and childbirth, particularly concerning clinical presentation and outcomes.

SEARCH STRATEGY: A systematic search of LitCovid, EBSCO MEDLINE, CENTRAL, CINAHL, Web of Science, and Scopus electronic databases. The references of relevant studies were also searched.

SELECTION CRITERIA: Identified titles and abstracts were screened to select original reports and cross-checked for overlap of cases.

DATA COLLECTION AND ANALYSIS: A descriptive summary organized by aspects of clinical presentations (symptoms, imaging, and laboratory) and outcomes (maternal and perinatal).

MAIN RESULTS: We identified 33 studies reporting 385 pregnant women with COVID-19 infection: 368 (95.6%) mild; 14 (3.6%) severe; and 3 (0.8%) critical. Seventeen women were admitted to intensive care, including six who were mechanically ventilated and one maternal mortality. A total of 252 women gave birth, comprising 175 (69.4%) cesarean and 77 (30.6%) vaginal births. Outcomes for 256 newborns included four RT-PCR positive neonates, two stillbirths, and one neonatal death.

CONCLUSION: COVID-19 infection during pregnancy probably has a clinical presentation and severity resembling that in non-pregnant adults. It is probably not associated with poor maternal or perinatal outcomes.

Ratings
Discipline / Specialty Area Score
Obstetrics
Pediatric Neonatology
Infectious Disease
Family Medicine (FM)/General Practice (GP)
FM/GP/Obstetrics
General Internal Medicine-Primary Care(US)
Hospital Doctor/Hospitalists
Internal Medicine
Comments from MORE raters

General Internal Medicine-Primary Care(US) rater

Mostly relevant for ob/gyn doctors, pediatricians, and some family practice physicians who manage pregnancy and newborns.

Infectious Disease rater

Reassuring data on the outcomes of COVID-19 during pregnancy. Missing data on treatment for COVID-19 during pregnancy.

Obstetrics rater

This is a useful, timely review.

Obstetrics rater

Information likely to change as more data are received. A series from Washington State published this week in AJOG suggests the disease is worse in pregnancy than non-pregnant women.