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COVID-19 Evidence Alerts
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Prognosis Trippella G, Ciarcia M, Ferrari M, et al. COVID-19 in Pregnant Women and Neonates: A Systematic Review of the Literature with Quality Assessment of the Studies. Pathogens. 2020 Jun 18;9(6). pii: pathogens9060485. doi: 10.3390/pathogens9060485.
Abstract

The SARS-CoV-2 virus emerged in December 2019 and then spread globally. Little is still known about the impact of COVID-19 on pregnant women and neonates. A review of the literature was performed according to the PRISMA guideline recommendations, searching the MEDLINE and EMBASE databases. Studies' quality assessments were performed using the JBI Critical Appraisal Checklist. A total of 37 studies were included, involving 275 pregnant women with COVID-19 and 248 neonates. The majority of pregnant women presented with mild to moderate symptoms, only 10 were admitted in the ICU, and one died. Two stillbirths were reported and the incidence of prematurity was 28%. Sixteen neonates were tested positive for SARS-CoV-2 by RT-PCR, and nine of them were born from mothers infected during pregnancy. Neonatal outcomes were generally good: all the affected neonates recovered. RT-PCR for SARS-CoV-2 yielded negative results on amniotic fluid, vaginal/cervical fluids, placenta tissue, and breast milk samples. SARS-CoV-2 infection in pregnant women appeared associated with mild or moderate disease in most cases, with a low morbidity and mortality rate. The outcomes of neonates born from infected women were mainly favorable, although neonates at risk should be closely monitored. Further studies are needed to investigate the possibility of vertical transmission.

Ratings
Discipline / Specialty Area Score
Infectious Disease
Respirology/Pulmonology
Obstetrics
Pediatric Neonatology
Hospital Doctor/Hospitalists
Internal Medicine
Intensivist/Critical Care
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Public Health
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Comments from MORE raters

Intensivist/Critical Care rater

In our current status under pandemic conditions and overwhelmed by medical literature, with dubius scientific standards, any systematic review will be incomplete and unupdated!

Internal Medicine rater

The review only used published data up to mid-April 2020; this ends up missing all the pre-print data (which has its pros and cons) and is already out of date given many new papers on this topic have just appeared in the last month.

Pediatric Neonatology rater

Great caution should be taken with the findings of this study. There are notable issues with many of the included studies, including the fact that some are rapidly published with no peer-review.

Public Health rater

The title is: "A Systematic Review of the Literature with Quality Assessment of the Studies." How can it be a systematic review without assessment of risk of bias? The limitations are that the percentage from one country is 66% and 76% had delivered.