Abstract
With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 245 pregnancies complicated by maternal SARS-CoV-2 infection across 48 studies listed on PubMed and MedRxiv. The most common clinical presentations were fever (55.9%), cough (36.3%), fatigue (11.4%), and dyspnea (12.7%). Only 4.1% of patients developed respiratory distress. Of all patients, 89.0% delivered via cesarean section (n = 201), with a 33.3% rate of gestational complications, a 35.3% rate of preterm delivery, and a concerning 2.5% rate of stillbirth delivery or neonatal death. Among those tested, 6.45% of newborns were reported positive for SARS-CoV-2 infection. Relative to known viral infections, the prognosis for pregnant women with SARS-CoV-2 is good, even in the absence of specific antiviral treatment. However, neonates and acute patients, especially those with gestational or preexisting comorbidities, must be actively managed to prevent the severe outcomes being increasingly reported in the literature.
Highlights
The emergence of SARS-CoV-2 as a novel infection in late December 2019 poses unique challenges to healthcare systems and practitioners
A case-control study conducted in Brazil on women infected with influenza A (H1N1) reported a higher rate of fetal deaths and preterm births among women who eventually died as a result of the infection, compared to women who had recovered
The papers we reviewed consist of 245 patients, all of whom are pregnant women with a confirmed diagnosis of SARSCoV-2, with a mean maternal age of 28.3 and a mean gestational age (GA) of 35.67 weeks
Summary
The emergence of SARS-CoV-2 as a novel infection in late December 2019 poses unique challenges to healthcare systems and practitioners. Chief among them is the management for pregnant women who are infected with SARS-CoV2. Pregnant women are prone to a range of fetal and maternal complications that could impact the outcome of any concurrent infection [1]. The late second and third trimesters carry an increased likelihood for the development of maternal conditions, such as gestational diabetes and hypertensive disorders, which contribute to maternal morbidity and premature birth. Many studies have investigated the maternal and neonatal outcomes in the setting of several recent epidemics such as influenza A (H1N1), SARS-CoV, Middle East Respiratory Syndrome (MERS), and Respiratory Syncytial Virus (RSV). A case-control study (deaths and recovered) conducted in Brazil on women infected with influenza A (H1N1) reported a higher rate of fetal deaths and preterm births among women who eventually died as a result of the infection, compared to women who had recovered.
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