COVID-19 infection during the third trimester of pregnancy: Current clinical dilemmas

Fontanella, F.; Hannes, S.; Keating, Niamh; Martyn, Fiona; Browne, I.; Briët, J. W.; McAuliffe, F; Baalman, Jelle

doi:10.1016/j.ejogrb.2020.05.053

Cited by 14 publications

(23 citation statements)

References 12 publications

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“…The meta-analysis was based on 745 COVID infected cases and 219 controls. A total of 34 case reports [ [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] ] yielding 45 cases were also included in the descriptive data analysis. Majority of the studies (12/34) were from China, 7 from the USA [ 62 , 67 , 68 , 70 , 76 , 85 , 87 ], 2 from Iran [ 63 , 80 ], 2 from Netherlands [ 82 , 83 ], 1 from Peru [ 75 ], 1 from Italy 1 [ 84 ], 1 from Sweden [ 64 ], 1 from Spain [ 73 ], 1 from Korea [ 55 ], 1 from Turkey [ 56 ], 1 from UK [ 78 ], 1 from Australia [ 88 ], 1 from Canada [ 79 ], 1 from Jordon [ 86 ], and 1 from India [ 72 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Case reports from Korea [ 55 ], India [ 72 ], Netherlands [ 82 , 83 ], Australia [ 88 ], Italy [ 84 ], Ireland [ 82 ], and Turkey [ 56 ] did not show any adverse pregnancy outcomes. All of these cases were detected after the gestation age of 35 weeks except for one case in a study [ 82 ]. However, cases from Peru [ 75 ], Spain [ 73 ], Iran [ 63 , 80 ], and UK [ 78 ] showed adverse pregnancy outcomes that may be due to early detection of infection before gestation age of 35 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Our study reports a 1 % prevalence of COVID-19 in neonates based on case series studies. Six neonates had COVID infection reported in case studies, one in vaginal delivery [ 63 ] and others in cesarean delivery [ 59 , 63 , 75 , 76 , 79 , 82 ]. The majority of mothers of these neonates had a fever, myalgia, other comorbidities, and received oxygen support and antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis

Dubey

Reddy

Manuel

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

165

135

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Objective Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. Study Designs PubMed search was performed of confirmed COVID-19 pregnant cases and related outcomes were ascertained prior to July 8, 2020, in this systematic review and meta-analysis. Studies reporting premature birth, low birth weight, COVID-19 infection in neonates, or mode of delivery status were included in the study. Two investigators independently performed searches, assessed quality of eligible studies as per the Cochrane handbook recommendations, extracted and reported data according to PRISMA guidelines. Pooled proportions of maternal and neonatal outcomes were estimated using meta-analyses for studies with varying sample sizes while a systematic review with descriptive data analysis was performed for case report studies. Maternal and neonatal outcomes included C-section, premature birth, low birth weight, adverse pregnancy events and COVID transmission in neonates. Results A total of 790 COVID-19 positive females and 548 neonates from 61 studies were analyzed. The rates of C-section, premature birth, low birth weight, and adverse pregnancy events were estimated as 72 %, 23 %, 7 %, and 27 % respectively. In the heterogeneity analysis, the rate of C-section was substantially higher in Chinese studies (91 %) compared to the US (40 %) or European (38 %) studies. The rates of preterm birth and adverse pregnancy events were also lowest in the US studies (12 %, 15 %) compared to Chinese (17 %, 21 %), and European studies (19 %, 19 %). In case reports, the rates of C-section, preterm birth, and low birth weight were estimated as 69 %, 56 %, and 35 %, respectively. Adverse pregnancy outcomes were associated with infection acquired at early gestational ages, more symptomatic presentation, myalgia symptom at presentation, and use of oxygen support therapy. Conclusions Adverse pregnancy outcomes were prevalent in COVID-19 infected females and varied by location, type, and size of the studies. Regular screening and early detection of COVID-19 in pregnant women may provide more favorable outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis

Dubey

Reddy

Manuel

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

165

135

View full text Add to dashboard Cite

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“…independently. A total of 70 studies met the inclusion criteria [ 5 , 7 , 9 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , <...>…”

Section: Resultsunclassified

Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review

et al. 2020

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The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, we conducted a systematic review to investigate pregnant women infected with COVID-19 in terms of signs and symptoms, type of delivery, comorbidities, maternal and neonatal outcomes, and the possibility of vertical transmission. A search on Embase and PubMed databases was performed on 31 October 2020. Observational studies and case reports on pregnant women infected with COVID-19 were included without language restrictions. The 70 selected studies included a total of 1457 pregnant women diagnosed with COVID-19 in the first, second, and third trimesters of pregnancy. The most common signs and symptoms were fever, cough, and nausea. The most frequent comorbidities were obesity, hypertensive disorders, and gestational diabetes. Among maternal and fetal outcomes, premature birth (n = 64), maternal death (n = 15), intrauterine fetal death or neonatal death (n = 16), cases of intrauterine fetal distress (n = 28), miscarriage (n = 7), decreased fetal movements (n = 19), and severe neonatal asphyxia (n = 5) were the most frequent. Thirty-nine newborns tested positive for SARS-CoV-2. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in the placenta (n = 13) and breast milk (n = 6). This review indicates that COVID-19 during pregnancy can result in maternal, fetal, and neonatal complications. In addition, SARS-CoV-2 viral exposure of neonates during pregnancy and delivery cannot be ruled out. Thus, we highlight the need for long-term follow-up of newborns from mothers diagnosed with COVID-19 to establish the full implications of SARS-CoV-2 infection in these children.

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Management of pregnant women with COVID‐19: A tertiary pandemic center experience on 1416 cases

Şahın

Tanaçan

Erol

et al. 2021

Journal of Medical Virology

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The aim of this study is to share the comprehensive experience of a tertiary pandemic center on pregnant women with COVID-19 and to compare clinical outcomes between pregnancy trimesters. The present prospective cohort study consisted of pregnant women with COVID-19 who were followed up at Ankara City Hospital between March 11, 2020 and February 20, 2021. Clinical characteristics and perinatal outcomes were compared between the pregnancy trimesters. A total of 1416 pregnant women (1400 singletons and 16 twins) with COVID-19 were evaluated.Twenty-six (1.8%) patients were admitted to the intensive care unit (ICU) and maternal mortality was observed in six (0.4%) cases. Pregnancy complications were present in 227 (16.1%) cases and preterm labor was the most common one (n = 42, 2.9%). There were 311, 433, and 672 patients in the first, second, and third trimesters of pregnancy, respectively. Rates of mild and severe/critic COVID-19 were highest in the first and second trimesters, respectively. The hospitalization rate was highest in the third trimester. Pregnancy complications, maternal mortality, and NICU admission rates were similar between the groups. The course of the disease and obstetric outcomes may be different among pregnancy trimesters. A worse course of the disease may be observed even in pregnant women without any coexisting health problems.

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COVID-19 infection during the third trimester of pregnancy: Current clinical dilemmas

Cited by 14 publications

References 12 publications

Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis

Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis

Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review

Management of pregnant women with COVID‐19: A tertiary pandemic center experience on 1416 cases

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