Current best evidence for clinical care (more info)
OBJECTIVE: To summarize currently available evidence on maternal, fetal, and neonatal outcomes of pregnant women infected with Coronavirus Disease 2019 (COVID-19).
MATERIAL AND METHODS: PubMed, Google Scholar, CNKI, Wanfang Data, VIP, and CBMdisc were searched for studies reporting maternal, fetal, and neonatal outcomes of women infected with COVID-19 published from 1 January 2020 to 26 March 2020. The protocol was registered with the Open Science Framework (DOI: 10.17605/OSF.IO/34ZAV).
RESULTS: In total, 18 studies comprising 114 pregnant women were included in the review. Fever (87.5%) and cough (53.8%) were the most commonly reported symptoms, followed by fatigue (22.5%), diarrhea (8.8%), dyspnea (11.3%), sore throat (7.5%), and myalgia (16.3%). The majority of patients (91%) had cesarean delivery due to various indications. In terms of fetal and neonatal outcomes, stillbirth (1.2%), neonatal death (1.2%), preterm birth (21.3%), low birth weight (<2500 g, 5.3%), fetal distress (10.7%), and neonatal asphyxia (1.2%) were reported. There are reports of neonatal infection, but no direct evidence of intrauterine vertical transmission has been found.
CONCLUSIONS: The clinical characteristics of pregnant women with COVID-19 are similar to those of non-pregnant adults. Fetal and neonatal outcomes appear good in most cases, but available data only include pregnant women infected in their third trimesters. Further studies are needed to ascertain long-term outcomes and potential intrauterine vertical transmission.
| Discipline / Specialty Area | Score |
|---|---|
| Obstetrics | |
| Infectious Disease | |
| FM/GP/Obstetrics | |
| Family Medicine (FM)/General Practice (GP) | |
| Pediatric Neonatology | |
Covid-19 is a new, challenging disease for doctors and compiling data in a systematic review is important for quality information to reach obstetricians who need to know how the infection occurs during pregnancy. However, this systematic review involved a small number of cases, 114, while there is a published review with the inclusion of 33 studies involving 385 pregnant women infected with the new coronavirus, https://doi.org/10.1002/ijgo.13182, which provides a better information to doctors, but also concludes that infection in pregnancy courses in a similar way as in the adult population. The most important information in this review is the main signs and symptoms of infection during pregnancy. Finally, the authors correctly present the study's limitations.
As an obstetrician, I find the SARS-CoV-2 pandemic has changed the everyday clinical practice, particularly in the emergency department and delivery ward. This systematic review provides useful information about the burden of COVID19 disease during pregnancy, and it can be helpful as a summary of the available evidence; although, the provided information is quite almost already know by the majority of clinicians.
I found this article very useful due to the serious spread of the COVID-19 outbreak. What the world is facing today reminds us how important all fields of medicine, research, and how important solidarity exchange is for humanity. This systematic review, therefore, that comprehensively summarized the perinatal outcomes in pregnant women with COVID-19 is of great importance. The review pointed out that the clinical characteristics of pregnant women with COVID-19 are similar to those of non-pregnant adults and that there is no evidence that COVID-19-infected pregnant women are more likely to develop severe pneumonia or death. Long-term outcomes and potential intrauterine vertical transmission, however, need further comprehensive analysis. In addition, further research related to this "new" coronavirus, its mutations, and coronavirus-related and potentially changing diseases should be continued.
The review concludes on low quality and retrospective data. 17 studies comprising live 84 births reported neonatal death (1.2%), preterm birth (21.3%), low birth weight (<2500 g, 5.3%), fetal distress (10.7%), and neonatal asphyxia (1.2%). Future studies, focusing on the long-term outcomes are necessary.
This is a systematic review of case-reports or case series. There are obvious limitations of such work. In addition, during the current climate, there are multiple similar reports being published with reduced scrutiny. Caution is recommended in interpreting these reports.