COVID-19 related Complications during Pregnancy: A Systematic Review

Abstract

Background: The topic of COVID-19 (coronavirus disease)-associated complications during pregnancy is poorly postulated and remains an area that requires elucidation for the underlying pathophysiology mechanism in order to evaluate a new therapeutic strategy and optimize current therapies. Aim: The study aimed to assess the proportion of associated complications with COVID-19 and the underlying pathophysiology in pregnant women. Methods: The MedLine and Embase databases were searched for studies relevant to the study topic. Results: Preterm delivery and C-section have been found to be the most frequently reported complications. Approximately, 28.55% of pregnant women with symptomatic COVID-19 have been reported to require a C-section and 8.8% preterm delivery. In addition, anxiety and depression have also been frequently reported in 57% and 37% of pregnant women, respectively. Conclusion: Symptomatic pregnant women with COVID-19 have a high risk of preterm labor, mortality and morbidity rates, and C-section requirements. The underlying pathophysiology of COVID-19-associated complications during pregnancy includes homeostatic disturbances of the immune system, pulmonary system, and hemostatic system. In addition to endothelial dysfunction, excessive immune response, coagulopathy, hypoxemia, and hypotension are involved in the pathogenesis that negatively affects neonates' health outcomes.