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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.
Obstet Gynecol. 2020 08; 136(2):303-312.OG

Abstract

OBJECTIVE

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.

DATA SOURCES

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.

METHODS OF STUDY SELECTION

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.

TABULATION, INTEGRATION, AND RESULTS

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).

CONCLUSION

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.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, CRD42020181497.

Authors+Show Affiliations

Departments of Family Medicine and Obstetrics and Gynecology, Clinica Family Health, Lafayette, Colorado; the Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Italy; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32516273

Citation

Huntley, Benjamin J F., et al. "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." Obstetrics and Gynecology, vol. 136, no. 2, 2020, pp. 303-312.
Huntley BJF, Huntley ES, Di Mascio D, et al. 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. Obstet Gynecol. 2020;136(2):303-312.
Huntley, B. J. F., Huntley, E. S., Di Mascio, D., Chen, T., Berghella, V., & Chauhan, S. P. (2020). 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. Obstetrics and Gynecology, 136(2), 303-312. https://doi.org/10.1097/AOG.0000000000004010
Huntley BJF, et al. 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. Obstet Gynecol. 2020;136(2):303-312. PubMed PMID: 32516273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Huntley,Benjamin J F, AU - Huntley,Erin S, AU - Di Mascio,Daniele, AU - Chen,Tracy, AU - Berghella,Vincenzo, AU - Chauhan,Suneet P, PY - 2020/6/10/pubmed PY - 2020/8/12/medline PY - 2020/6/10/entrez SP - 303 EP - 312 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 136 IS - 2 N2 - OBJECTIVE: 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. DATA SOURCES: 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. METHODS OF STUDY SELECTION: 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. TABULATION, INTEGRATION, AND RESULTS: 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). CONCLUSION: 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. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020181497. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/32516273/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_ L2 - https://doi.org/10.1097/AOG.0000000000004010 DB - PRIME DP - Unbound Medicine ER -