Abstract
Introduction: Although the number of studies conducted among pregnant women with coronavirus (COVID-19) is increasing rapidly, most of the studies are small-scale. Accordingly, data on the relationship between COVID-19 and pregnancy are limited. In addition, there is limited information about which complications COVID-19 causes in pregnant women compared to the normal population, and at what rates. This meta-analysis aimed to examine the data of studies and metaanalyses on pregnancies with COVID-19, and to determine the complication rates caused by COVID- 19 in pregnancies.
Methods: Clinical, observational, or cohort studies published (or epub ahead of print) between January 2020 and December 2021 in any language were scanned in PubMed and Google Scholar. While scanning, the combinations of the terms “COVID-19”, “SARS-CoV-2”, “coronavirus”, “pregnancy”, “PROM”, or “preterm birth” were used.
Results: A total of 52 articles and data on 11088 pregnant women were included in the meta-analysis after the screening of 6166 studies. In addition, data belonging to 10 meta-analyses were examined in order to obtain additional information. In the studies covered by this meta-analysis, the rate of premature rupture of membranes was found in 16.8%; preterm birth in 10.3%; low birth weight newborns in 9.2%; maternal or fetal mortality in 3.0%, and other adverse outcomes (fetal distress or abnormal APGAR score, abortion, etc.) in 17.5%. The vertical contamination rate was found to be 2.1%.
Conclusion: The findings obtained in this meta-analysis show that COVID-19 significantly increases the maternal or fetal mortality rate in pregnant women and has a negative effect on the preterm birth rate. According to the data we have obtained, COVID-19 also causes the development of some complications, such as fetal distress. The findings also show that COVID-19 is transmitted vertically at a rate of around 2% during pregnancy.
Graphical Abstract
[http://dx.doi.org/10.1186/s12575-020-00128-2] [PMID: 32774178]
[http://dx.doi.org/10.1016/j.pop.2018.05.013] [PMID: 30115342]
[http://dx.doi.org/10.1172/JCI87490] [PMID: 28459427]
[http://dx.doi.org/10.1111/aji.12355] [PMID: 25582523]
[http://dx.doi.org/10.1055/s-0040-1713408] [PMID: 32559801]
[http://dx.doi.org/10.1371/journal.pmed.1000100] [PMID: 19621070]
[http://dx.doi.org/10.1097/XEB.0000000000000054] [PMID: 26317388]
[http://dx.doi.org/10.1001/jamainternmed.2020.9241] [PMID: 33449067]
[http://dx.doi.org/10.1016/j.jogoh.2020.101826] [PMID: 32505805]
[http://dx.doi.org/10.15585/mmwr.mm6938e1] [PMID: 32970655]
[http://dx.doi.org/10.1136/bmj.m2107] [PMID: 32513659]
[http://dx.doi.org/10.1001/jamanetworkopen.2020.29256] [PMID: 33211113]
[http://dx.doi.org/10.1001/jama.2020.10125] [PMID: 32511673]
[http://dx.doi.org/10.1097/AOG.0000000000004025] [PMID: 32555034]
[http://dx.doi.org/10.1093/cid/ciaa1411] [PMID: 32947612]
[http://dx.doi.org/10.1001/jama.2020.19124] [PMID: 32965467]
[http://dx.doi.org/10.1007/s13224-020-01335-3] [PMID: 32760169]
[http://dx.doi.org/10.1016/j.ejogrb.2020.11.068] [PMID: 33310656]
[http://dx.doi.org/10.1056/NEJMc2009226] [PMID: 32302077]
[http://dx.doi.org/10.1016/j.ajog.2020.04.014] [PMID: 32335053]
[http://dx.doi.org/10.3201/eid2609.202144] [PMID: 32633712]
[http://dx.doi.org/10.1002/jmv.26631] [PMID: 33107604]
[http://dx.doi.org/10.15585/mmwr.mm6938e2] [PMID: 32970660]
[http://dx.doi.org/10.1080/14767058.2020.1861599] [PMID: 33322959]
[http://dx.doi.org/10.1016/j.ejogrb.2020.09.012] [PMID: 32950276]
[http://dx.doi.org/10.1097/AOG.0000000000003979] [PMID: 32433453]
[http://dx.doi.org/10.1111/1471-0528.16403] [PMID: 32633022]
[http://dx.doi.org/10.3390/jcm9113552] [PMID: 33158175]
[http://dx.doi.org/10.1055/s-0040-1712164] [PMID: 32428964]
[http://dx.doi.org/10.1186/s12916-020-01798-1] [PMID: 33070775]
[http://dx.doi.org/10.1001/jamanetworkopen.2020.30455] [PMID: 33351086]
[http://dx.doi.org/10.1016/j.ajog.2020.09.043] [PMID: 32986989]
[http://dx.doi.org/10.1002/jmv.26725] [PMID: 33314206]
[http://dx.doi.org/10.1111/aogs.13921] [PMID: 32441332]
[http://dx.doi.org/10.1016/j.ajog.2020.03.021] [PMID: 32217113]
[http://dx.doi.org/10.1016/j.ajog.2020.06.022] [PMID: 32553908]
[http://dx.doi.org/10.1055/s-0040-1718403] [PMID: 32992351]
[http://dx.doi.org/10.1111/his.14215] [PMID: 32692408]
[http://dx.doi.org/10.1016/j.ajogmf.2020.100211] [PMID: 32838277]
[http://dx.doi.org/10.1101/2020.06.11.20128652] [PMID: 32959805]
[http://dx.doi.org/10.1016/j.ajog.2020.05.031] [PMID: 32439389]
[http://dx.doi.org/10.1016/j.ajogmf.2020.100118] [PMID: 32292903]
[http://dx.doi.org/10.1111/1471-0528.16278] [PMID: 32339382]
[http://dx.doi.org/10.1371/journal.pone.0239887] [PMID: 32991621]
[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/10.1016/j.ejogrb.2020.07.008] [PMID: 32732059]
[http://dx.doi.org/10.1007/s11684-020-0772-y] [PMID: 32285380]
[http://dx.doi.org/10.1016/j.cmi.2020.03.034] [PMID: 32278081]
[http://dx.doi.org/10.1093/cid/ciaa352] [PMID: 32249918]
[http://dx.doi.org/10.1002/ijgo.13236] [PMID: 32438521]
[http://dx.doi.org/10.1093/ajcp/aqaa089] [PMID: 32441303]
[http://dx.doi.org/10.2214/AJR.20.23072] [PMID: 32186894]
[http://dx.doi.org/10.1016/j.jinf.2020.02.028] [PMID: 32145216]
[http://dx.doi.org/10.1016/j.ajog.2020.06.020] [PMID: 32553910]
[http://dx.doi.org/10.1002/ijgo.13188] [PMID: 32350871]
[http://dx.doi.org/10.21037/tp.2020.02.06] [PMID: 32154135]
[http://dx.doi.org/10.1136/bmj.m3320] [PMID: 32873575]
[http://dx.doi.org/10.1002/uog.23619] [PMID: 33620113]
[http://dx.doi.org/10.1186/s40001-020-00439-w] [PMID: 32887660]
[http://dx.doi.org/10.1016/j.ejogrb.2020.07.034] [PMID: 32795828]
[http://dx.doi.org/10.1002/ijgo.13182] [PMID: 32330287]
[http://dx.doi.org/10.1002/uog.22088] [PMID: 32430957]
[http://dx.doi.org/10.1186/s12879-020-05274-2] [PMID: 32746801]
[http://dx.doi.org/10.1016/j.ejogrb.2020.07.006] [PMID: 32713730]
[http://dx.doi.org/10.1159/000509290] [PMID: 32728006]
[http://dx.doi.org/10.1111/aogs.13867] [PMID: 32259279]
[http://dx.doi.org/10.1590/0102-311x00087320] [PMID: 32696830]
[http://dx.doi.org/10.1016/j.clp.2004.06.004] [PMID: 15519427]
[http://dx.doi.org/10.1159/000360342] [PMID: 25906886]
[http://dx.doi.org/10.1007/s00134-010-1951-0] [PMID: 20631987]
[http://dx.doi.org/10.1111/jth.15072] [PMID: 32846051]
[http://dx.doi.org/10.1053/beog.1999.0069] [PMID: 10789266]
[http://dx.doi.org/10.1016/0002-9378(90)90901-I] [PMID: 2193513]
[http://dx.doi.org/10.1111/ajo.13204] [PMID: 32779193]