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COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review.
Gynecol Obstet Invest. 2020; 85(4):295-306.GO

Abstract

INTRODUCTION

To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner.

METHODS

A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale.

RESULTS

Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%).

CONCLUSION

COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers.

Authors+Show Affiliations

Department of Medicine, St George's, University of London, London, United Kingdom.Department of Medicine, St George's, University of London, London, United Kingdom.Faculty of Medicine, Imperial College London, London, United Kingdom.Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom, aaharky@gmail.com. Department of Integrative Biology, Faculty of Life Science, University of Liverpool, Liverpool, United Kingdom, aaharky@gmail.com.

Pub Type(s)

Systematic Review

Language

eng

PubMed ID

32728006

Citation

Akhtar, Hubba, et al. "COVID-19 (SARS-CoV-2) Infection in Pregnancy: a Systematic Review." Gynecologic and Obstetric Investigation, vol. 85, no. 4, 2020, pp. 295-306.
Akhtar H, Patel C, Abuelgasim E, et al. COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. Gynecol Obstet Invest. 2020;85(4):295-306.
Akhtar, H., Patel, C., Abuelgasim, E., & Harky, A. (2020). COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. Gynecologic and Obstetric Investigation, 85(4), 295-306. https://doi.org/10.1159/000509290
Akhtar H, et al. COVID-19 (SARS-CoV-2) Infection in Pregnancy: a Systematic Review. Gynecol Obstet Invest. 2020;85(4):295-306. PubMed PMID: 32728006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. AU - Akhtar,Hubba, AU - Patel,Chandni, AU - Abuelgasim,Eyad, AU - Harky,Amer, Y1 - 2020/07/30/ PY - 2020/05/09/received PY - 2020/06/09/accepted PY - 2020/7/31/pubmed PY - 2020/10/21/medline PY - 2020/7/31/entrez KW - Coronavirus disease 2019 KW - Foetus KW - Pregnancy KW - Preterm delivery KW - Vertical transmission SP - 295 EP - 306 JF - Gynecologic and obstetric investigation JO - Gynecol Obstet Invest VL - 85 IS - 4 N2 - INTRODUCTION: To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner. METHODS: A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale. RESULTS: Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%). CONCLUSION: COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers. SN - 1423-002X UR - https://www.unboundmedicine.com/medline/citation/32728006/COVID_19__SARS_CoV_2__Infection_in_Pregnancy:_A_Systematic_Review_ L2 - https://www.karger.com?DOI=10.1159/000509290 DB - PRIME DP - Unbound Medicine ER -