International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020
Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Turan Ozlem, Hakim Amir, Dashraath Pradip, Jeslyn Wong Jing Lin, Wright Alison, Abdul-Kadir Rezan
Аннотация
BACKGROUND: Pregnant women represent a potentially high-risk population in the COVID-19 pandemic.
OBJECTIVE: To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID-19.
SEARCH STRATEGY: Relevant databases were searched up until May 29, 2020.
SELECTION CRITERIA: Case series/reports of hospitalized pregnant women with laboratory-confirmed COVID-19.
DATA COLLECTION AND ANALYSIS: PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools.
MAIN RESULTS: Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory-confirmed SARS-CoV-2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D-dimer and interleukin-6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID-19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours.
CONCLUSIONS: Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D-dimer and interleukin-6 levels are predictive of poor pregnancy outcomes in COVID-19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.
OBJECTIVE: To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID-19.
SEARCH STRATEGY: Relevant databases were searched up until May 29, 2020.
SELECTION CRITERIA: Case series/reports of hospitalized pregnant women with laboratory-confirmed COVID-19.
DATA COLLECTION AND ANALYSIS: PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools.
MAIN RESULTS: Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory-confirmed SARS-CoV-2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D-dimer and interleukin-6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID-19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours.
CONCLUSIONS: Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D-dimer and interleukin-6 levels are predictive of poor pregnancy outcomes in COVID-19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.