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Maternal death related to COVID‐19: A systematic review and meta‐analysis focused on maternal co‐morbidities and clinical characteristics
Author(s) -
La Verde Marco,
Riemma Gaetano,
Torella Marco,
Cianci Stefano,
Savoia Fabiana,
Licciardi Federico,
Scida Serena,
Morlando Maddalena,
Colacurci Nicola,
De Franciscis Pasquale
Publication year - 2021
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.13726
Subject(s) - medicine , relative risk , gestational diabetes , confidence interval , cochrane library , meta analysis , maternal death , intensive care , mechanical ventilation , medline , pregnancy , gestational age , obstetrics , pediatrics , intensive care medicine , gestation , population , environmental health , biology , political science , law , genetics
Background Besides reducing the quality of obstetric care, the direct impact of COVID‐19 on pregnancy and postpartum is uncertain. Objective To evaluate the characteristics of pregnant women who died due to COVID‐19. Search strategy Cochrane Library, Embase, MEDLINE, Scopus, and Google Scholar were searched from inception to February 2021. Selection criteria Studies that compared deceased and survived pregnant women with COVID‐19. Data collection and analysis Relevant data were extracted and tabulated. The primary outcome was maternal co‐morbidity. Main results Thirteen studies with 154 deceased patients were included. Obesity doubled the risk of death (relative risk [RR] 2.48, 95% confidence interval [CI] 1.41–4.36, I 2 = 0%). No differences were found for gestational diabetes (RR 5.71; 95% CI 0.77–42.44, I 2 = 94%) or asthma (RR 2.05, 95% CI 0.81–5.15, I 2 = 0%). Overall, at least one severe co‐morbidity showed a twofold increased risk of death (RR 2.26, 95% CI 1.77–2.89, I 2 = 76%). Admission to intensive care was related to a fivefold increased risk of death (RR 5.09, 95% CI 2.00–12.98, I 2 = 56%), with no difference in need for respiratory support (RR 0.53, 95% CI 0.23–1.48, I 2 = 95%) or mechanical ventilation (RR 4.34, 95% CI 0.96–19.60, I 2 = 58%). Conclusion COVID‐19 with at least one co‐morbidity increases risk of intensive care and mortality.