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Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis.
BMC Infect Dis. 2020 Aug 03; 20(1):564.BI

Abstract

BACKGROUND

The recent COVID-19 outbreak in Wuhan, China, has quickly spread throughout the world. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19.

METHODS

PubMed, Web of Science, EMBASE and MEDLINE were searched from January 1, 2020, to April 16, 2020. Case reports and case series of pregnant women infected with SARS-CoV-2 were included. Two reviewers screened 366 studies and 14 studies were included. Four reviewers independently extracted the features from the studies. We used a random-effects model to analyse the incidence (P) and 95% confidence interval (95% CI). Heterogeneity was assessed using the I2 statistic.

RESULTS

The meta-analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95% CI, 0.49-0.93), caesarean section (65%; 95% CI, 0.42-0.87), fever (51%; 95% CI, 0.35-0.67), lymphopenia (49%; 95% CI, 0.29-0.70), coexisting disorders (33%; 95% CI, 0.21-0.44), cough (31%; 95% CI, 0.23-0.39), fetal distress (29%; 95% CI, 0.08-0.49), preterm labor (23%; 95% CI, 0.14-0.32), and severe case or death (12%; 95% CI, 0.03-0.20). The subgroup analysis showed that compared with non-pregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women, 51%; non-pregnant patients, 91%; P < 0.00001) and cough (pregnant women, 31%; non-pregnant patients, 67%; P < 0.0001).

CONCLUSIONS

The incidences of fever, cough and positive CT findings in pregnant women with COVID-19 are less than those in the normal population with COVID-19, but the rate of preterm labor is higher among pregnant with COVID-19 than among normal pregnant women. There is currently no evidence that COVID-19 can spread through vertical transmission.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China.Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Postal address: No. 20, Section 3, South Renmin Road, Cheng Du, Sichuan province, 610041, P. R. China. zhourong_hx@scu.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32746801

Citation

Gao, Yi-Jie, et al. "Clinical Features and Outcomes of Pregnant Women With COVID-19: a Systematic Review and Meta-analysis." BMC Infectious Diseases, vol. 20, no. 1, 2020, p. 564.
Gao YJ, Ye L, Zhang JS, et al. Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. BMC Infect Dis. 2020;20(1):564.
Gao, Y. J., Ye, L., Zhang, J. S., Yin, Y. X., Liu, M., Yu, H. B., & Zhou, R. (2020). Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. BMC Infectious Diseases, 20(1), 564. https://doi.org/10.1186/s12879-020-05274-2
Gao YJ, et al. Clinical Features and Outcomes of Pregnant Women With COVID-19: a Systematic Review and Meta-analysis. BMC Infect Dis. 2020 Aug 3;20(1):564. PubMed PMID: 32746801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. AU - Gao,Yi-Jie, AU - Ye,Lei, AU - Zhang,Jia-Shuo, AU - Yin,Yang-Xue, AU - Liu,Min, AU - Yu,Hong-Biao, AU - Zhou,Rong, Y1 - 2020/08/03/ PY - 2020/04/30/received PY - 2020/07/20/accepted PY - 2020/8/5/entrez PY - 2020/8/5/pubmed PY - 2020/8/22/medline KW - COVID-19 KW - Clinical features KW - Meta-analysis KW - Pregnancy outcomes KW - Pregnant women KW - SARS-CoV-2 SP - 564 EP - 564 JF - BMC infectious diseases JO - BMC Infect Dis VL - 20 IS - 1 N2 - BACKGROUND: The recent COVID-19 outbreak in Wuhan, China, has quickly spread throughout the world. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19. METHODS: PubMed, Web of Science, EMBASE and MEDLINE were searched from January 1, 2020, to April 16, 2020. Case reports and case series of pregnant women infected with SARS-CoV-2 were included. Two reviewers screened 366 studies and 14 studies were included. Four reviewers independently extracted the features from the studies. We used a random-effects model to analyse the incidence (P) and 95% confidence interval (95% CI). Heterogeneity was assessed using the I2 statistic. RESULTS: The meta-analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95% CI, 0.49-0.93), caesarean section (65%; 95% CI, 0.42-0.87), fever (51%; 95% CI, 0.35-0.67), lymphopenia (49%; 95% CI, 0.29-0.70), coexisting disorders (33%; 95% CI, 0.21-0.44), cough (31%; 95% CI, 0.23-0.39), fetal distress (29%; 95% CI, 0.08-0.49), preterm labor (23%; 95% CI, 0.14-0.32), and severe case or death (12%; 95% CI, 0.03-0.20). The subgroup analysis showed that compared with non-pregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women, 51%; non-pregnant patients, 91%; P < 0.00001) and cough (pregnant women, 31%; non-pregnant patients, 67%; P < 0.0001). CONCLUSIONS: The incidences of fever, cough and positive CT findings in pregnant women with COVID-19 are less than those in the normal population with COVID-19, but the rate of preterm labor is higher among pregnant with COVID-19 than among normal pregnant women. There is currently no evidence that COVID-19 can spread through vertical transmission. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/32746801/Clinical_features_and_outcomes_of_pregnant_women_with_COVID_19:_a_systematic_review_and_meta_analysis_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05274-2 DB - PRIME DP - Unbound Medicine ER -