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Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review.
Int J Gynaecol Obstet. 2020 Oct; 151(1):7-16.IJ

Abstract

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.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Royal Free Hospital NHS Trust, London, UK. EGA Institute for Women's Health, University College London, London, UK.National Heart and Lung Institute, Imperial College London, London, UK. Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Department of Obstetrics and Gynecology, Royal Free Hospital NHS Trust, London, UK.Department of Obstetrics and Gynecology, Royal Free Hospital NHS Trust, London, UK. EGA Institute for Women's Health, University College London, London, UK.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32816307

Citation

Turan, Ozlem, et al. "Clinical Characteristics, Prognostic Factors, and Maternal and Neonatal Outcomes of SARS-CoV-2 Infection Among Hospitalized Pregnant Women: a Systematic Review." International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics, vol. 151, no. 1, 2020, pp. 7-16.
Turan O, Hakim A, Dashraath P, et al. Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. Int J Gynaecol Obstet. 2020;151(1):7-16.
Turan, O., Hakim, A., Dashraath, P., Jeslyn, W. J. L., Wright, A., & Abdul-Kadir, R. (2020). Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics, 151(1), 7-16. https://doi.org/10.1002/ijgo.13329
Turan O, et al. Clinical Characteristics, Prognostic Factors, and Maternal and Neonatal Outcomes of SARS-CoV-2 Infection Among Hospitalized Pregnant Women: a Systematic Review. Int J Gynaecol Obstet. 2020;151(1):7-16. PubMed PMID: 32816307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. AU - Turan,Ozlem, AU - Hakim,Amir, AU - Dashraath,Pradip, AU - Jeslyn,Wong Jing Lin, AU - Wright,Alison, AU - Abdul-Kadir,Rezan, Y1 - 2020/08/30/ PY - 2020/07/11/received PY - 2020/07/21/accepted PY - 2020/8/21/pubmed PY - 2020/12/22/medline PY - 2020/8/21/entrez KW - COVID-19 KW - Intrauterine fetal demise KW - Maternal morbidity KW - Maternal mortality KW - Miscarriage KW - Neonatal morbidity KW - Neonatal mortality KW - Preterm birth SP - 7 EP - 16 JF - International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics JO - Int J Gynaecol Obstet VL - 151 IS - 1 N2 - 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. SN - 1879-3479 UR - https://www.unboundmedicine.com/medline/citation/32816307/Clinical_characteristics_prognostic_factors_and_maternal_and_neonatal_outcomes_of_SARS_CoV_2_infection_among_hospitalized_pregnant_women:_A_systematic_review_ L2 - https://doi.org/10.1002/ijgo.13329 DB - PRIME DP - Unbound Medicine ER -