The impact of COVID-19 during pregnancy on maternal and neonatal outcomes: a systematic review

Authors

  • Despoina Michailidou Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Androniki Stavridou Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Eleni D. Panagouli Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Theodoros N. Sergentanis Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Theodora Psaltopoulou Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens
  • Flora Bacopoulou University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens
  • Valentina Baltag Department of Maternal, Newborn, Child & Adolescent Health & Ageing, World Health Organization
  • Donald E. Greydanus Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine
  • George Mastorakos Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, Aretaieion Hospital
  • George Chrousos University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens
  • Maria N. Tsolia Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Artemis K. Tsitsika Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens
  • Nikolaos Vlahos Second Department of Obstetrics and Gynecology, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens

DOI:

https://doi.org/10.14806/ej.26.1.969

Keywords:

COVID-19, pregnancy, caesarean section, delivery, novel coronavirus, SARS-CoV-2

Abstract

Several months after the onset of the epidemic, COVID-19 remains a global health issue. Scientific data on pregnancy, perinatal outcomes and vertical transmission of SARS-CoV-2 are constantly emerging but are still limited and unclear. The purpose of this systematic review was to summarize current evidence on vertical transmission rates, maternal, perinatal and neonatal outcomes and mode of delivery in pregnancies affected by COVID-19. An extensive search was conducted in PubMed, Google Scholar, Embase, and Scopus databases up to June 20, 2020. A total of 133 articles (51 case reports, 31 case series, 40 cohort studies and 2 case-control studies) reporting data from 8,092 subjects (6,046 pregnant women and 2,046 neonates) were considered eligible for inclusion in the systematic review. A substantial proportion of pregnant women with COVID-19 underwent caesarean section (case reports 82.2%, case series 74.2% and cohort studies 66.0%). Regarding vertical transmission, most neonates were tested negative (case reports 92.7%, case series studies 84.2%, cohort studies 97.1% and case control studies 100%). Maternal mortality rates ranged from 1% in cohort studies to 5.7% in case reports; neonatal mortality ranged from 2% in case reports to 3.3% in case series. Vertical transmission of SARS-CoV-2 from mother to child is rare. Careful screening of pregnant women seems important and specific guidelines with evidence-based decision algorithms for the mode of delivery in the context of a pregnancy affected by COVID-19 should be established.  

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Published

2021-10-22

Issue

Vol. 26: Special issue to Biostatistics and Mathematical Modelling in Bioinformatics

Section

Reviews

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