Consequences and implications of the coronavirus disease (COVID‐19) on pregnancy and newborns: A comprehensive systematic review and meta‐analysis

Abstract

Background Pregnant patients are potentially vulnerable to COVID‐19. Objectives To clarify the clinical features of COVID‐19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients. Search strategy Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus. Selection criteria Articles published from December 2019 to February 2021. Data collection and analysis The reviewers extracted relevant data from the full‐text. Data synthesis was performed using the R‐4.1.0 Project for Statistical Computing for Windows. The meta‐analysis of the included studies was carried out using the random‐effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis. Results A total of 70 studies included 10 047 pregnant women with COVID‐19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17–0.34, I2 = 93%) and via cesarean delivery (42%, 95% CI 0.38–0.47, I2 = 92%). There were 108 maternal mortalities (2%, 95% CI 0.01–0.03, I2 = 54%) and 50 abortions (5%, 95% CI 0.03–0.09, I2 = 73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06–0.19, I2 = 91%), birth weight (15%, 95% CI 0.10–0.21, I2 = 76%), APGAR <7 (19%, 95% CI 0.12–0.28, I2 = 43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17–0.43, I2 = 90%), and fetal mortality (2%, 95% CI 0.01–0.03, I2 = 46%). Conclusion There was no evidence of severe acute respiratory syndrome coronavirus‐2 in the placenta, breast milk, umbilical cord, and amniotic fluid of pregnant patients. PROSPERO registration number: CRD42020181519.

COVID-19 and vaccination during pregnancy: a systematic analysis using Korea National Health Insurance claims data

“…The phenomenon of lower preterm birth and cesarean section in pregnant women with COVID-19 require careful assessment. Several studies have reported a higher rate of preterm birth and cesarean section in pregnant women with COVID-19; however, some results are contradictory [12][13][14][15][16][17][18][19]. In addition, the most frequent causes of early emergency cesarean sections were reported to be fetal distress and worsening respiratory symptoms in pregnant women with COVID-19 [19].…”

COVID-19: Consequences on pregnant women and neonates

“…The study comprised 10,047 expectant mothers with COVID-19, out of which 71.6% were in their 3 rd trimester. Pregnant patients' placenta, breast milk, navel string, and amniotic fluid did not indicate COVID-19 [82] .…”

Investigación e innovación biomédica ante la sindemia por COVID-19. Informe SESPAS 2022

“…En nuestro medio 18 y en otros países 19 se ha criticado la falta de datos desagregados por sexo/género sobre indicadores clínicos y epidemiológicos de la COVID-19. Respecto a la salud reproductiva, se ha resumido la evidencia sobre el efecto de la COVID-19 en el acceso a servicios de aborto, anticonceptivos y pruebas del virus de la inmunodeficiencia humana, además de cambios en los comportamientos sexuales, menstruación e intenciones de embarazo 20 , y efectos durante el embarazo 21 , procesos perinatales 22 y violencia machista 23 .…”