COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Prognosis Akhtar H, Patel C, Abuelgasim E, et al. COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. Gynecol Obstet Invest. 2020 Jul 30:1-12. doi: 10.1159/000509290.
Abstract

INTRODUCTION: To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner.

METHODS: A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale.

RESULTS: Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%).

CONCLUSION: COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers.

Ratings
Discipline / Specialty Area Score
Infectious Disease
Obstetrics
Pediatric Neonatology
Family Medicine (FM)/General Practice (GP)
Comments from MORE raters

Obstetrics rater

I found article very useful and important in obstetrics during COVID-19 pandemia. There is not enough evidence so far that COVID-19 infected infected pregnant women are more likely to develop severe pneumonia or death. There is not enough evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child, as well. However, according to the presented results, COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth (3 times the higher rate compared to the general pregnant population), PPROM, and may possibly lead to maternal death in rare cases. Further studies should be undertaken to investigate and monitor possible infection in the neonates to COVID-19-infected mothers. Long-term outcomes and potential intrauterine vertical transmission need further and serious analysis.

Pediatric Neonatology rater

COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers. The meta-analysis provided useful data on this topic. However, the evidence should improve. Now, there have an article published suggestimg that the transmission of SARS-2-CoV should happen.