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Consequences and implications of the coronavirus disease (COVID‐19) on pregnancy and newborns: A comprehensive systematic review and meta‐analysis
Author(s) -
Medeiros Kleyton S.,
Sarmento Ayane C. A.,
Costa Ana P. F.,
Macêdo Luíza T. de A.,
Silva Luís A. S.,
Freitas Cijara L.,
Simões Ana C. Z.,
Gonçalves Ana K.
Publication year - 2022
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.14015
Subject(s) - medicine , confidence interval , meta analysis , pregnancy , neonatal intensive care unit , obstetrics , apgar score , fetal distress , covid-19 , medline , pediatrics , birth weight , fetus , disease , genetics , infectious disease (medical specialty) , biology , political science , law
Background Pregnant patients are potentially vulnerable to COVID‐19. Objectives To clarify the clinical features of COVID‐19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients. Search strategy Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus. Selection criteria Articles published from December 2019 to February 2021. Data collection and analysis The reviewers extracted relevant data from the full‐text. Data synthesis was performed using the R‐4.1.0 Project for Statistical Computing for Windows. The meta‐analysis of the included studies was carried out using the random‐effects model (DerSimonian and Laird). Heterogeneity was measured using I 2 analysis. Results A total of 70 studies included 10 047 pregnant women with COVID‐19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17–0.34, I 2 = 93%) and via cesarean delivery (42%, 95% CI 0.38–0.47, I 2 = 92%). There were 108 maternal mortalities (2%, 95% CI 0.01–0.03, I 2 = 54%) and 50 abortions (5%, 95% CI 0.03–0.09, I 2 = 73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06–0.19, I 2 = 91%), birth weight (15%, 95% CI 0.10–0.21, I 2 = 76%), APGAR <7 (19%, 95% CI 0.12–0.28, I 2 = 43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17–0.43, I 2 = 90%), and fetal mortality (2%, 95% CI 0.01–0.03, I 2 = 46%). Conclusion There was no evidence of severe acute respiratory syndrome coronavirus‐2 in the placenta, breast milk, umbilical cord, and amniotic fluid of pregnant patients. PROSPERO registration number: CRD42020181519.