Abstract
Background: Pregnant women are a vulnerable group in viral outbreaks, especially in the COVID-19 pandemic.
Objective: The aim of this review was to identify maternal and neonatal outcomes in available articles on pregnancies affected by COVID-19.
Methods: The articles that had assessed outcomes of pregnancy and perinatal of women with COVID-19 between Oct 2019 and Aug 2020 without language limitation were considered. We searched databases, selected relevant studies and extracted data regarding maternal and neonatal outcomes from each article.
Results: Data of 11078 pregnant women with COVID-19 of 23 countries were assessed from 77 articles between December 8, 2019 and Aug 18, 2020. Most pregnant women reported in their third trimester, out of which 6229 (56.22%) cases were symptomatic at the time of admission. Common onset symptoms, abnormal laboratory findings, and chest computed tomography pattern were cough (40.88%%), lymphocytopenia (43.38%), and multiple ground-glass opacities (4.42%), respectively. 51.37% of all deliveries were done through cesarean section. 158 maternal mortality and 4.2% ICU admission were reported. Vertical transmission was not reported, but its possibility was suggested in thirty-two neonates. Ten neonatal deaths, thirteen stillbirths, and nineteen abortions were reported. 60% of newborns were not breastfed.
Conclusion: This review showed fewer adverse maternal and neonatal outcomes in pregnant women with COVID-19 in comparison with previous coronavirus outbreak infection in pregnancy. Limited data are available regarding the possibility of virus transmission in utero, during vaginal childbirth and breastfeeding. The effect of COVID-19 on the first and second trimesters and ongoing pregnancy outcomes in infected mothers is still questionable.
Keywords: COVID-19, coronavirus infections, pregnancy, maternal, neonate, perinatal.
Graphical Abstract
[PMID: 32191675]
[http://dx.doi.org/10.1111/aji.12355] [PMID: 25582523]
[http://dx.doi.org/10.1186/s12879-016-1437-y] [PMID: 26936356]
[http://dx.doi.org/10.1016/j.ajog.2003.11.019] [PMID: 15295381]
[http://dx.doi.org/10.1097/AOG.0b013e3181d57947] [PMID: 20308830]
[http://dx.doi.org/10.2174/1381612824666180130121946] [PMID: 29384053]
[http://dx.doi.org/10.1056/NEJMe1801398] [PMID: 29539290]
[http://dx.doi.org/10.1056/NEJMra1213566] [PMID: 24897084]
[http://dx.doi.org/10.1007/s12026-012-8303-9] [PMID: 22447351]
[http://dx.doi.org/10.1016/S0966-3274(02)00017-5] [PMID: 12180824]
[http://dx.doi.org/10.1186/s40348-017-0070-1] [PMID: 28432664]
[http://dx.doi.org/10.1016/j.it.2004.04.007] [PMID: 15207501]
[http://dx.doi.org/10.1038/nri1394] [PMID: 15229474]
[http://dx.doi.org/10.1111/j.1600-0897.2008.00682.x] [PMID: 19239422]
[http://dx.doi.org/10.4049/jimmunol.1000289] [PMID: 20554966]
[http://dx.doi.org/10.1111/j.1600-0897.2010.00836.x] [PMID: 20367629]
[http://dx.doi.org/10.3389/fimmu.2020.01022] [PMID: 32574260]
[http://dx.doi.org/10.2214/AJR.20.23072] [PMID: 32186894]
[http://dx.doi.org/10.3201/eid2606.200287] [PMID: 32134381]
[http://dx.doi.org/10.3389/fped.2020.00104] [PMID: 32266184]
[http://dx.doi.org/10.1016/S0140-6736(20)30360-3] [PMID: 32151335]
[http://dx.doi.org/10.1001/jama.2020.4621]
[http://dx.doi.org/10.1093/cid/ciaa200] [PMID: 32119083]
[PMID: 32145714]
[http://dx.doi.org/10.1016/j.jinf.2020.02.028] [PMID: 32145216]
[http://dx.doi.org/10.1002/jmv.25789] [PMID: 32222119]
[http://dx.doi.org/10.1016/S1473-3099(20)30176-6]
[http://dx.doi.org/10.21037/tp.2020.02.06] [PMID: 32154135]
[http://dx.doi.org/10.1093/cid/ciaa226] [PMID: 32182347]
[http://dx.doi.org/10.1016/j.jmii.2020.03.004] [PMID: 32198004]
[http://dx.doi.org/10.1016/j.jinf.2020.03.007] [PMID: 32171865]
[http://dx.doi.org/10.1101/2020.03.22.20041061]
[http://dx.doi.org/10.1101/2020.03.24.20042176]
[http://dx.doi.org/10.1007/s12630-020-01630-7] [PMID: 32180175]
[http://dx.doi.org/10.3760/cma.j.cn112151-20200225-00138] [PMID: 32114744]
[http://dx.doi.org/10.4097/kja.20116] [PMID: 32229802]
[http://dx.doi.org/10.1002/jmv.25857] [PMID: 32275072]
[http://dx.doi.org/10.1111/aogs.13862] [PMID: 32249924]
[http://dx.doi.org/10.1016/j.tmaid.2020.101639] [PMID: 32222420]
[http://dx.doi.org/10.1016/j.ajogmf.2020.100111] [PMID: 32518902]
[http://dx.doi.org/10.1056/NEJMc2007605] [PMID: 32237670]
[http://dx.doi.org/10.1001/jama.2020.4861] [PMID: 32215589]
[http://dx.doi.org/10.1001/jama.2020.7233] [PMID: 32352491]
[http://dx.doi.org/10.1001/jamapediatrics.2020.0878] [PMID: 32215598]
[http://dx.doi.org/10.1002/ijgo.13165] [PMID: 32270479]
[http://dx.doi.org/10.3760/cma.j.cn113903-20200220-00134]
[http://dx.doi.org/10.4274/balkanmedj.galenos.2020.2020.3.89] [PMID: 32212578]
[PMID: 32283217]
[http://dx.doi.org/10.1002/ijgo.13162] [PMID: 32267531]
[http://dx.doi.org/10.1017/ice.2020.84] [PMID: 32279693]
[http://dx.doi.org/10.1002/uog.22034] [PMID: 32249471]
[http://dx.doi.org/ 10.1016/j.ajog.2020.05.031] [PMID: 32439389]
[http://dx.doi.org/10.1016/j.ajogmf.2020.100113] [PMID: 32363336]
[http://dx.doi.org/10.1055/s-0040-1712164] [PMID: 32428964]
[http://dx.doi.org/10.1055/s-0040-1712529] [PMID: 32438425]
[http://dx.doi.org/10.1055/s-0040-1713664] [PMID: 32544963]
[http://dx.doi.org/10.15585/mmwr.mm6925a1] [PMID: 32584795]
[http://dx.doi.org/10.1016/j.ajog.2020.04.029] [PMID: 32371056]
[http://dx.doi.org/10.1136/bmj.m2107] [PMID: 32513659]
[http://dx.doi.org/10.1016/j.ejogrb.2020.05.025] [PMID: 32425297]
[http://dx.doi.org/10.1080/14767058.2020.1797669] [PMID: 32715804]
[http://dx.doi.org/10.1002/pd.5713] [PMID: 32304114]
[http://dx.doi.org/10.1016/j.ajog.2020.04.030] [PMID: 32360108]
[http://dx.doi.org/10.1097/AOG.0000000000003979] [PMID: 32433453]
[http://dx.doi.org/10.1016/j.thromres.2020.04.022] [PMID: 32371163]
[http://dx.doi.org/10.3390/medicina56060306] [PMID: 32580461]
[http://dx.doi.org/10.1089/bfm.2020.0095] [PMID: 32311273]
[http://dx.doi.org/10.1111/ajo.13173] [PMID: 32294229]
[http://dx.doi.org/10.1016/j.crwh.2020.e00240] [PMID: 32714844]
[http://dx.doi.org/10.1111/aogs.13901] [PMID: 32386441]
[http://dx.doi.org/10.1186/s13006-020-00314-8] [PMID: 32770999]
[http://dx.doi.org/10.1016/j.rceng.2020.04.005] [PMID: 32313302]
[http://dx.doi.org/10.1016/j.eclinm.2020.100407] [PMID: 32632417]
[http://dx.doi.org/10.1016/j.anpede.2020.03.002] [PMID: 32363217]
[http://dx.doi.org/10.1016/j.ejogrb.2020.05.007] [PMID: 32439245]
[http://dx.doi.org/10.1016/j.ejogrb.2020.05.029] [PMID: 32425298]
[http://dx.doi.org/10.1016/j.ejogrb.2020.06.002] [PMID: 32540156]
[http://dx.doi.org/10.1016/S2352-4642(20)30140-1] [PMID: 32386562]
[http://dx.doi.org/10.1111/jth.14856] [PMID: 32302459]
[http://dx.doi.org/10.1007/s13224-020-01335-3] [PMID: 32760169]
[http://dx.doi.org/10.1016/j.crwh.2020.e00212] [PMID: 32523874]
[http://dx.doi.org/10.22207/JPAM.14.2.06]
[http://dx.doi.org/10.1055/s-0040-1710050] [PMID: 32305046]
[http://dx.doi.org/10.1016/j.tmaid.2020.101805] [PMID: 32593868]
[http://dx.doi.org/10.1016/j.ajog.2020.04.014] [PMID: 32335053]
[http://dx.doi.org/10.1016/j.jinf.2020.05.014] [PMID: 32417313]
[http://dx.doi.org/10.1503/cmaj.200553] [PMID: 32376643]
[http://dx.doi.org/10.1007/s11684-020-0772-y] [PMID: 32285380]
[http://dx.doi.org/10.3390/v12020194] [PMID: 32050635]
[http://dx.doi.org/10.1111/j.1471-0528.2004.00199.x] [PMID: 15270922]
[http://dx.doi.org/10.3346/jkms.2017.32.10.1717] [PMID: 28875620]
[http://dx.doi.org/10.1093/cid/ciw412] [PMID: 27358348]
[http://dx.doi.org/10.4097/kjae.2016.69.3.287] [PMID: 27274377]
[http://dx.doi.org/10.3201/eid2203.151049] [PMID: 26890613]
[http://dx.doi.org/10.1093/infdis/jiu068] [PMID: 24474813]
[http://dx.doi.org/10.1016/S1473-3099(20)30244-9] [PMID: 32224313]
[http://dx.doi.org/10.3201/eid1002.030736] [PMID: 15030710]
[http://dx.doi.org/10.3201/eid1009.040244] [PMID: 15503406]
[http://dx.doi.org/10.1016/S2214-109X(18)30451-0] [PMID: 30389451]
[http://dx.doi.org/10.1038/s41598-019-52015-w] [PMID: 31664121]
[http://dx.doi.org/10.1016/j.ajogmf.2020.100110] [PMID: 32518901]
[http://dx.doi.org/10.1080/01459740.2020.1761804] [PMID: 32406755]
[http://dx.doi.org/10.1002/14651858.CD010406.pub3] [PMID: 30798570]
[http://dx.doi.org/10.1186/s13054-016-1230-8] [PMID: 27036638]
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[http://dx.doi.org/10.1136/fn.88.5.F405] [PMID: 12937045]
[http://dx.doi.org/10.1159/000078174] [PMID: 15218286]
[http://dx.doi.org/10.1542/peds.112.4.e254] [PMID: 14523207]
[http://dx.doi.org/10.1136/adc.2005.075309] [PMID: 16244207]
[http://dx.doi.org/10.1001/jama.2020.4868] [PMID: 32215579]
[http://dx.doi.org/10.21037/atm.2020.02.20]
[http://dx.doi.org/10.1111/aogs.13867] [PMID: 32259279]
[http://dx.doi.org/10.1002/ijgo.13166] [PMID: 32271947]
[http://dx.doi.org/10.1002/uog.22014] [PMID: 32180292]
[http://dx.doi.org/10.1002/ijgo.13182] [PMID: 32330287]
[http://dx.doi.org/10.1097/AOG.0000000000004010] [PMID: 32516273]