COVID-19 pneumonia and pregnancy; a systematic review and meta-analysis

Abstract

Background: The new SARS-CoV-2 originated from Wuhan, China is spreading rapidly worldwide. A number of SARS-CoV-2 positive pregnant women have been reported. However, more information is still needed on the pregnancy outcome and the neonates regarding COVID-19 pneumonia. Material and Methods: A systematic search was done and nine articles on COVID-19 pneumonia and SARS-CoV-2 positive pregnant women were extracted. Some maternal-fetal characteristics were extracted to be included in the meta-analysis. Results: The present meta-analysis was conducted on 87 SARS-CoV-2 positive pregnant women. Almost 65% of the patients reported a history of exposure to an infected person, 78% suffered from mild or moderate COVID-19, 99.9% had successful termination, 86% had cough, and 68% had fever (p ¼ .022 and p < .001). The overall proportions of vertical transmission, still birth, and neonatal death were zero, 0.002, and, 0.002, respectively (p ¼ 1, p ¼ .86, and p ¼ .89, respectively). The means of the first-and fifth-minute Apgar scores were 8.86 and 9, respectively (p < .001 for both). The confounding role of history of underlying diseases with an estimated overall proportion of 33% (p ¼ .03) resulted in further investigations due to sample size limitation. A natural history of COVID-19 pneumonia in the adult population was presented, as well. Conclusion: Currently, no evidence of vertical transmission has been suggested at least in late pregnancy. No hazards have been detected for fetuses or neonates. Although pregnant women are at an immunosuppressive state due to the physiological changes during pregnancy, most patients suffered from mild or moderate COVID-19 pneumonia with no pregnancy loss, proposing a similar pattern of the clinical characteristics of COVID-19 pneumonia to that of other adult populations.

COVID‐19‐related disease severity in pregnancy

“…disease with the majority of cases occurring in the late second and third trimesters. 10,31,[44][45][46]49,60,[84][85][86][87][88][89][90] Little data are available on the effects of infection occurring in the first or early second trimesters.…”

Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis

“…COVID-19 shares several features with SARS-CoV-1 and MERS-CoV, and seems to have a similar pathogenic potential [ 11 , 12 ]. Two early meta-analyses showed that a high percentage of pregnant women affected by these infections experienced unfavourable pregnancy outcomes and that there was no evidence of vertical transmission [ 13 , 14 ]. However, both meta-analyses included small numbers of patients.…”

Covid-19 and Children; What Have We Learned So Far?

“…(sırasıyla p = 1, p = 0,86 ve p = 0,89) Birinci ve beşinci dakikada Apgar skorlarının ortalaması ise sırasıyla 8,86 ve 9,0 olarak bulunmuştur. (her ikisi için de p <,001) Bu çalışmada dikey bulaşma kanıtı, fetüs veya yenidoğan için herhangi bir tehlike olmadığı gözlemlenmiştir (41) Yapılan bir meta analiz çalışmasında (33 çalışma ve 19 vaka raporunun dahil edildiği) çocukların %17,4'nün (% 95 GA= 9,1-27,3) asemptomatik olduğu, ateş (% 51,2,% 95 GA = 40,2-62,2) ve öksürüğün (% 37,0,% 95 CI = 25,9-48,8) ise en sık semptomlar olduğunu belirlemiştir. Şiddetli veya kritik hastalık prevalansı yaklaşık olarak % 0 olduğu saptanmıştır (% 95 GA = 0-1,0).…”