Maternal and Neonatal Complications, Outcomes and Possibility of Vertical Transmission in Iranian Women with COVID-19.

Zohreh Heidary,Hanieh Fathi,Marjan Ghaemi,Batool Hossein Rashidi,Majid Zaki-Dizaji,Omid Kohandel

doi:10.34172/aim.2021.104

Abstract

The emergence and fast spread of coronavirus disease 2019 (COVID-19) threatens the world as a new public health crisis. Little is known about its effects during pregnancy. This study aimed to investigate the clinical manifestations of COVID-19 on maternal and neonatal outcomes. In this systematic review, PubMed, Scopus, Web of Science, and Google Scholar databases were searched focusing on pregnancy and perinatal outcomes of COVID-19. The initial search yielded 1236 articles, from which finally 21 unique studies, involving 151 pregnant women and 17 neonates, met the criteria. Mean ± SD age of included mothers and mean ± SD gestational age at admission were 30.6 ± 6.2 years and 30.8 ± 8.9 weeks, respectively. The common symptoms were fever, cough, fatigue, dyspnea and myalgia. The mortality rates of pregnant women and neonates were 28 out of 151 (18.5%) and 4 out of 17 (23.5%), respectively. Most of the neonates were preterm at the time of delivery. Three neonates had positive RT-PCR test on the first day after birth and three others on day two. On the average, neonate's PCR became positive on day 4 for the first time. Early diagnosis of COVID-19 is crucial due to the possibility of the prenatal complications. Strict prevention strategies may reduce the risk of mother to infant transmission.

Highlights

The emergence and fast spread of novel coronavirus disease 2019 (COVID-19) which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), threatens the world as a new public health crisis
Normal ranges and units: white blood cells (WBC) count (4.4×109/L–11×109/L); lymphocyte percentage (20%–40%); CRP ( < 1 mg/dL), SPO2 ( > 95%), BUN (7 mg/dL–20 mg/dL), Cr (0.84 mg/dL–1.21mg/dL), ESR ( < 20 mm/h), AST ( < 31U/L), ALT ( < 31U/L), Plt (165–415×109/L). *These findings were reported as lymphocyte count. **These finding were presented as median and IQR, to estimate the mean and standard deviation we considered median as mean and standard deviation to be IQR/1.35. because these variables seemed to have normal distribution
It was found that pregnant women who expired or developed IUFD had an average lower SpO2, indicating that women with more severe lung involvement were at higher risk of maternal and neonate mortality than those with mild lung involvement

Summary

Introduction

The emergence and fast spread of novel coronavirus disease 2019 (COVID-19) which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), threatens the world as a new public health crisis. Coronavirus can infect anyone, pregnant women are more susceptible to this virus due to physiological and immunological alterations during pregnancy.[3,4] Currently, there is very limited knowledge about the various aspects of the coronavirus including during pregnancy and maternal and neonatal health before and after delivery. The emergence and fast spread of coronavirus disease 2019 (COVID-19) threatens the world as a new public health crisis. Results: The initial search yielded 1236 articles, from which 21 unique studies, involving 151 pregnant women and 17 neonates, met the criteria.

Objectives

Methods

Results

Conclusion