Background. Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19. Methods. Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions. Results. 117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term. Conclusion. COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women.

Background The association between passive smoking (PS) and cardiovascular disease (CVD) has not yet been fully clarified. Objective This meta‐analysis was performed to evaluate the association between PS and the incidence of CVDs and mortality due to CVD. Methods PubMed/Medicine, Science Direct, Scopus, Web of Knowledge, and ProQuest were searched to identify observational studies that met the inclusion criteria without time, language, age, gender, ethnicity, and design restrictions until July 30, 2018. In case–control studies, relative risk (RR) with 95% confidence interval (CI) was calculated for the relationship between PS and CVD incidence. Also, in cohort studies, hazard ratio (HR) with 95% CI was calculated for the relationship between PS and CVD mortality. Results Eighteen studies (10 cohort and 8 case–control studies) were included with 10,672 participants (2,542 cases and 8,130 controls) in case–control studies and 2,313,935 participants in cohort studies. This meta‐analysis in case–control studies revealed that the PS could increase the risk of CVD incidence by 28% (adjusted RR = 1.28 [95% CI 1.09, 1.50]), where the highest risk was associated with those who were exposed to second‐hand smoke at home and at work (Adjusted RR = 1.41 [95% CI 0.73, 2.70]). Also, the meta‐analysis in cohort studies indicated that PS was associated with a 12% higher increase in the risk of CVD mortality (Adjusted HR = 1.12 [95% CI 1.06, 1.20]) with the highest risk of mortality being observed for those who were exposed to second‐hand smoking at home, work, and public places (Adjusted HR = 1.26 [95% CI 1.13, 1.40]). Conclusions PS is significantly associated with an increased risk of incidence and mortality of CVD.

The clinical implementation of a birth ball exercise could be an effective tool for parturient women to reduce labor pain. However, rigorous RCTs are needed to evaluate the effect of the birth ball on labor pain relief.

Background: COVID-19 is a new disease, so we don’t know what comes next. Since information on delayed symptoms is limited, this study was conducted to assess the frequency of delayed symptoms in patients with COVID-19. Methods: This follow-up cross-sectional study was conducted in a referral general hospital in Tehran, Iran from Feb to Apr 2020. Two hundred patients hospitalized for COVID-19 and were discharged were assessed for delayed symptoms 6 wk after discharge. Results: The mean age of the participants was 55.58±13.52, and 160 (80%) Of them were male. On admission to hospital, patients reported a mean of 5.63±2.88 symptoms per patient, range from 1 to 14 symptoms. Dyspnea was seen in 119 (59.5%) 0f them as the most frequent symptom. Then weakness, myalgia, and shivering were reported with a frequency of 111 (55.5%), 107 (53.5%), and 103 (51.5%), respectively. Six weeks after discharge reassessment was done. None of the patients was readmitted to the hospital. Ninety-four (42%) of them were symptom-free. Fatigue was the most frequent delayed symptom with a frequency of 39 (19.5%), and then dyspnea, weakness, and activity intolerance with a frequency of 37 (18.5%), 36 (18%), and 29 (14.5%) were reported, respectively. Conclusion: Fatigue, dyspnea, weakness, anxiety, and activity intolerance were most frequent delayed symptoms, respectively. Majority of patient was symptoms free and those with symptom, had mild to moderate symptoms. The importance of symptoms is not fully recognized. Follow up clinics and in some cases rehabilitation programs may be helpful