Abstract
The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on impact of COVID-19 infection on perinatal outcomes. Databases of Medline, Embase, and Cochrane library were searched using the keywords related to COVID-19 and perinatal outcomes from December 2019 to 30 June 2021. Observational studies comparing the perinatal outcomes of COVID-19 infection in pregnancy with a non-infected comparator were included. The screening process and quality assessment of the included studies were performed independently by two reviewers. Meta-analyses were used to pool the comparative dichotomous data on perinatal outcomes. The database search yielded 4049 results, 1254 of which were duplicates. We included a total of 21 observational studies that assessed the adverse perinatal outcomes with COVID-19 infection. The odds of maternal death (pooled OR: 7.05 [2.41−20.65]), preeclampsia (pooled OR: 1.39 [1.29−1.50]), cesarean delivery (pooled OR: 1.67 [1.29−2.15]), fetal distress (pooled OR: 1.66 [1.35−2.05]), preterm birth (pooled OR: 1.86 [1.34−2.58]), low birth weight (pooled OR: 1.69 [1.35−2.11]), stillbirth (pooled OR: 1.46 [1.16−1.85]), 5th minute Apgar score of less than 7 (pooled OR: 1.44 [1.11−1.86]) and admissions to neonatal intensive care unit (pooled OR: 2.12 [1.36−3.32]) were higher among COVID-19 infected pregnant women compared to non-infected pregnant women.
Highlights
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, continues to be an alarming global public health crisis [1] with a sharply escalating number of deaths that have largely surpassed previous fatalities caused by epidemics such as Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) [2]
Two thousand seven hundred ninety-five (2795) studies were identified through the search engines for the title and abstract reviews after removing 1254 duplicates
Of the 20 studies included except the multinational study, eight (40%) were from the United States of America (USA) [15,16,20,23,24,25,29,31] three (15%) were from Spain [18,19,26], two (10%) each from Mexico [17,30] and India [21,27] and one (5%) each from Iran [14], United Kingdom (UK) [34], France [22], Sweden [28] and Canada [32]
Summary
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, continues to be an alarming global public health crisis [1] with a sharply escalating number of deaths that have largely surpassed previous fatalities caused by epidemics such as Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) [2]. At the time of writing (3 December 2021), 263,563,622 confirmed cases of COVID-19, including 5,232,562 deaths, had been reported to the World Health Organization (WHO) [3]. This situation raises concerns in vulnerable populations such as pregnant mothers, fetuses and their neonates. Proven up-to-date evidence of maternal, fetal, and neonatal risks associated with COVID-19 infection in pregnancy is an urgent need to guide clinical decision-making in maternal and child health care. The prevalence of COVID-19 related adverse perinatal outcomes and the comorbidity profiles of COVID-19 infected pregnant women are essential variables that would help inform care and preventative services
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