Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review

Smith, Vinayak; Seo, Densearn; Warty, Ritesh Rikain; Payne, Olivia; Salih, M. A. M.; Chin, Ken Lee; Ofori‐Asenso, Richard; Krishnan, Sathya; Costa, Fabrício da Silva; Vollenhoven, Beverley; Wallace, Euan

doi:10.1371/journal.pone.0234187

Cited by 259 publications

(381 citation statements)

References 33 publications

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“…Increased rates of preterm births and caesarean deliveries have also been observed in previous reports on maternal and neonatal COVID 19 infection. Preterm rate of as high as 63% and caesarean delivery rate of 80% has been described in the systematic review of 9 studies by Smith et al [38] Noteworthy is that the rate of stillbirths in this cohort (57 per 1000 total births) is higher than pre-COVID 19 rate of 34 per 1000 total births. Though the causative association with COVID 19 is uncertain, this aspect of COVID 19 effect on pregnancy outcomes needs to be evaluated in further studies.…”

Section: Discussionmentioning

confidence: 70%

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

et al. 2020

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Despite rapidly evolving knowledge about COVID 19 infection, routes of perinatal COVID 19 transmission and viral load in mother neonate dyad remain uncertain. Data were analysed to describe the clinicodemographic profile and viral load in neonates born to COVID 19 positive mothers. Of 2947 deliveries, 69 mothers were COVID 19 positive (2.3%), with 1 abortion, 2 macerated stillbirths and 2 fresh stillbirths as pregnancy outcomes. Of 65 tested neonates, 10.7% (7) were confirmed COVID 19 positive by RTPCR (reverse transcriptase-polymerase chain reaction). Viral load (cycle threshold, Ct of E, RDRp) in neonates was comparable with the Ct reported from adults; however, neonates had milder clinical manifestations. All 7 neonates who tested positive for COVID 19 were subsequently discharged. Six of the 7 neonates were asymptomatic and 1 neonate needed respiratory support (indication being prematurity) which resolved after 48 h. Maternal and neonatal comparison of Ct of E and RdRp gene was statistically non-significant (25.97 vs 19.68, p = 0.34 and 26.5 vs 25.0, p = 0.84). Viral loads of mothers with COVID 19 positive neonates compared with mothers with COVID 19 negative neonates for E and RdRp gene were also statistically non-significant (25 vs 27.19, p = 0.63 and 19.6 vs 27.6, p = 0.08). The majority (93%) of neonates tested later than 48 h (roomed in with mother and breastfed) tested negative. Conclusion: The study supports milder manifestation in COVID 19 positive neonates. Risk of transmission from COVID 19 positive mother to neonate by rooming-in and breastfeeding is low. In this study on a limited number of neonates, maternal viral load was not found to be associated with the positivity status or severity of the illness of neonate.

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Section: Discussionmentioning

confidence: 70%

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

et al. 2020

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“…A laboratory confirmed case of COVID-19 was defined as a positive result on quantitative reverse-transcriptasepolymerase-chain-reaction (qRT-PCR) assay of Naso-pharyngeal swab specimens for adults and neonates.The kit for qRTPCR was designed by National Institute of Virology Pune (India) conforming to the national guidelines by ICMR(Indian Council of Medical Research) named LabGun TM COVID-19 RT-PCR kit, which ran primer probes through initial screening for E (envelope) gene specific to Sarbeco subgenus. Screen positive samples were confirmed positive if either of the two SARS-CoV-2 specific gene vide RDRp (RNA dependent RNA polymerase) gene or ORF-1bnsp14b gene was detected.. 12 Data extracted from the patient records included demographics, comorbidities, symptomatology, pregnancy outcomes and information on neonates (including birthweight, apgar score, and perinatal complications).Also noted were the laboratory tests,Ct values, drug therapy and length of hospital stay (LOS). Maternal deaths amongst this cohort were scrutinised.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Clinical Profile, Viral Load, Maternal-Fetal Outcomes of Pregnancy With COVID-19: 4-Week Retrospective, Tertiary Care Single-Centre Descriptive Study

Bachani

Arora

Dabral

et al. 2021

Journal of Obstetrics and Gynaecology Canada

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Introduction The COVID19 pandemic raises a major concern about its severity in pregnancy, fetomaternal outcomes and risk of vertical transmission.The Cycle threshold indicating the viral load can be a contributory factor towards modifying the management of such pregnant women. We report a retrospective descriptive study regarding the clinical course, fetomaternal outcomes of pregnant women with COVID19. Methodology This is a single-center, retrospective study performed in a tertiary care hospital for pregnant women with COVID-19 in India. The medical records of the all women who delivered in the Covid facility from May 5th 2020 to June 5th 2020 were reviewed independently. Data extracted from the records included demography, obstetric details, co morbidities, disease severity, investigations, management and information on neonates (birthweight, Apgar score, and perinatal complications).Statistical analysis was performed by the SPSS program for Windows, version 17.0(SPSS, Chicago, Illinois) Results Amongst 348 women(suspects) tested for SARS-CoV-2, 57 women ( 57/348,16.3%) were confirmed positive based on qRT-PCR of nasopharyngeal specimen. Most women (45 /78.9 %) had mild infection with favourable fetomaternal outcomes. Three maternal mortalities were associated with co morbidities. Five neonates tested positive for SARS-CoV-2, remained haemodynamically stable and were subsequently discharged. Conclusions Majority of pregnant women with Covid-19 had mild disease and recovered subsequently with good perinatal outcomes. Women with co morbidities may have increased risk of severe morbidity and mortality.The Cycle threshold signifying the viral load and degree of infectivity can modify the management during pregnancy.Long-term outcomes and the potential mother-to-child vertical/horizontal transmission needs further study.

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“…This database (https://collaborate.aap.org/SONPM/Pages?National-Perinatal-COVID19-Registry.aspx) has reported 1,106 mother-infant dyads with 33 positive infants with short-term outcomes as of June 21, 2020. These databases and published reports demonstrate that compared with elderly population, the morbidity and mortality are low among obstetric 6 and neonatal patients. [13][14][15] However, long-term outcomes of perinatal COVID-19 are not known.…”

mentioning

confidence: 75%

“…[3][4][5] SARS-CoV-2 infection in pregnancy has other consequences, even if the mother remains asymptomatic or have mild disease. 6,7 Pregnant women who test positive for SARS-CoV-2 require isolation and special care during labor, vaginal delivery, or cesarean. [8][9][10] Visitors or support persons may not be allowed, and the mother may not be able to visit the nursery if the newborn requires additional care.…”

mentioning

confidence: 99%

Perinatal COVID-19 Infection Prevention: Infographics for Patients and Providers

et al. 2020

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Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review

Cited by 259 publications

References 33 publications

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

Clinical Profile, Viral Load, Maternal-Fetal Outcomes of Pregnancy With COVID-19: 4-Week Retrospective, Tertiary Care Single-Centre Descriptive Study

Perinatal COVID-19 Infection Prevention: Infographics for Patients and Providers

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