Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection: A Systematic Review

To ascertain the frequency of maternal and neonatal complications, as well as maternal disease severity, in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. MEDLINE, Ovid, ClinicalTrials.gov, MedRxiv, and Scopus were searched from their inception until...

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Veröffentlicht in:Obstetrics and gynecology (New York. 1953) Jg. 136; H. 2; S. 303
Hauptverfasser: Huntley, Benjamin J F, Huntley, Erin S, Di Mascio, Daniele, Chen, Tracy, Berghella, Vincenzo, Chauhan, Suneet P
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.08.2020
Schlagworte:
Betacoronavirus
Cesarean Section - statistics & numerical data
Coronavirus Infections - mortality
Coronavirus Infections - transmission
COVID-19
Female
Hospitalization
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical - statistics & numerical data
Maternal Mortality
Pandemics
Perinatal Mortality
Pneumonia, Viral - mortality
Pneumonia, Viral - transmission
Pregnancy
Pregnancy Complications, Infectious - mortality
Pregnancy Complications, Infectious - virology
Pregnancy Outcome
Premature Birth - epidemiology
Premature Birth - virology
SARS-CoV-2
ISSN:1873-233X, 1873-233X
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Zusammenfassung:To ascertain the frequency of maternal and neonatal complications, as well as maternal disease severity, in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. MEDLINE, Ovid, ClinicalTrials.gov, MedRxiv, and Scopus were searched from their inception until April 29, 2020. The analysis was limited to reports with at least 10 pregnant patients with SARS-CoV-2 infection that reported on maternal and neonatal outcomes. Inclusion criteria were pregnant women with a confirmed diagnosis of SARS-CoV-2 infection. A systematic search of the selected databases was performed by implementing a strategy that included the MeSH terms, key words, and word variants for "coronavirus," "SARS-CoV-2," "COVID-19," and "pregnancy.r The primary outcomes were maternal admission to the intensive care unit (ICU), critical disease, and death. Secondary outcomes included rate of preterm birth, cesarean delivery, vertical transmission, and neonatal death. Categorical variables were expressed as percentages with number of cases and 95% CIs. Of the 99 articles identified, 13 included 538 pregnancies complicated by SARS-CoV-2 infection, with reported outcomes on 435 (80.9%) deliveries. Maternal ICU admission occurred in 3.0% of cases (8/263, 95% CI 1.6-5.9) and maternal critical disease in 1.4% (3/209, 95% CI 0.5-4.1). No maternal deaths were reported (0/348, 95% CI 0.0-1.1). The preterm birth rate was 20.1% (57/284, 95% CI 15.8-25.1), the cesarean delivery rate was 84.7% (332/392, 95% CI 80.8-87.9), the vertical transmission rate was 0.0% (0/310, 95% CI 0.0-1.2), and the neonatal death rate was 0.3% (1/313, 95% CI 0.1-1.8). With data from early in the pandemic, it is reassuring that there are low rates of maternal and neonatal mortality and vertical transmission with SARS-CoV-2. The preterm birth rate of 20% and the cesarean delivery rate exceeding 80% seems related to geographic practice patterns. PROSPERO, CRD42020181497.
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ISSN:1873-233X
1873-233X
DOI:10.1097/AOG.0000000000004010