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Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review
Author(s) -
Turan Ozlem,
Hakim Amir,
Dashraath Pradip,
Jeslyn Wong Jing Lin,
Wright Alison,
AbdulKadir Rezan
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13329
Subject(s) - medicine , pregnancy , population , case fatality rate , obstetrics , observational study , gestational diabetes , diabetes mellitus , pediatrics , gestation , genetics , environmental health , biology , endocrinology
Background Pregnant women represent a potentially high‐risk population in the COVID‐19 pandemic. Objective To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID‐19. Search strategy Relevant databases were searched up until May 29, 2020. Selection criteria Case series/reports of hospitalized pregnant women with laboratory‐confirmed COVID‐19. Data collection and analysis PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools. Main results Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory‐confirmed SARS‐CoV‐2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D‐dimer and interleukin‐6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID‐19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours. Conclusions Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D‐dimer and interleukin‐6 levels are predictive of poor pregnancy outcomes in COVID‐19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.