Obstetrics and Neonatal Outcomes in Pregnant Women with COVID-19: A Systematic Review
-
Mojdeh BANAEI
,
Vida GHASEMI
,
Marzieh SAEI GHARE NAZ
,
Zahra KIANI
,
Farzaneh RASHIDI-FAKARI
,
Sedigheh BANAEI
,
Behzad MOHAMMAD SOURI
,
Mohsen ROKNI
Abstract
Background: Considering that the obstetricians and pediatricians need to comprehensive information about the obstetric and neonatal effect of COVID-19, this review study was conducted to investigate the impact of COVID-19 on obstetrics and neonatal outcomes.
Methods: In this systematic review the international search databases following PubMed, Web of Science, Scopus, ProQuest and Embase and Google scholar were searched. All articles were reviewed by two independent researchers until 10 April 2020. After quality assessment of included studies the finding reported in 2 sections obstetrics and neonatal outcomes.
Results: The sixteen studies with a sample size of 123 pregnant women with a definitive diagnosis of COVID-19 and their neonates were evaluated. The range of gestational age was 25-40 weeks. There was no death associated with COVID-19 in pregnant women. The obstetric outcomes in pregnant women with COVID-19 include decreased fetal movement, intrauterine fetal distress, anemia, PROM, preterm labor, Multiple Organ Dysfunction Syndrome (MODS) and etc. The most common delivery mode in women affect with COVID-19 was cesarean section. Expect for one case with MODS, in the majority of the studies reviewed, no severe morbidity or mortality occurred. The neonatal outcomes were stillbirth, prematurity, asphyxia, fetal distress, low birth weight, small for gestational age, large for gestational age, multiple organ dysfunction syndrome, disseminated intravascular coagulation and neonatal death. In addition, five neonates born to mothers with COVID-19 were positive for SARS-CoV-2. However, the studies report these outcomes but the exact causes of theme are not known.
Conclusion: In this systematic review, we summarize the diverse results of studies about the obstetrics and neonatal outcomes following COVID-19. This infection may cause negative outcomes in both mothers and neonates. However, there were evidence about neonate infected with COVID-19, but there is controversial information about the vertical transmission of COVID-19.
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11. Wong SF, Chow KM, Leung TN et al (2004). Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol, 191(1): 292-7.
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14. Chen S, Liao E, Shao Y (2020). Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Vi-rol, doi: 10.1002/jmv.25789.
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16. Khan S, Peng L, Siddique R et al (2020). Im-pact of COVID-19 infection on preg-nancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infect Control Hosp Epidemiol, 1-3.
17. Panahi L, Amiri M, Pouy S (2020). Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review. Arch Acad Emerg Med, 8(1): e34.
18. Luchini C, Stubbs B, Solmi M, Veronese N (2017). Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World J Metaanal, 5(4):80-4.
19. Kanthraj G, Srinivas C (2005). Journal Club: screen, select, probe & evaluate. Indian J Dermatol Venereol Leprol, 71(6):435-40.
20. Chen H, Guo J, Wang C et al (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 in-fection in nine pregnant women: a retro-spective review of medical records. Lancet, 395(10226):809-15.
21. Song L, Xiao W, Ling K, Yao S, Chen X (2020). Anesthetic Management for Emergent Cesarean Delivery in a Parturi-ent with Recent Diagnosis of Corona-virus Disease 2019 (COVID-19): A Case Report. Transl Perioper & Pain, 7(3): 234-237.
22. Chen Y, Peng H, Wang L et al (2020). In-fants born to mothers with a new coro-navirus (COVID-19). Front Pediatr, 8:1-5.
23. Yu N, Li W, Kang Q et al (2020). Clinical features and obstetric and neonatal out-comes of pregnant patients with COVID-19 in Wuhan, China: a retro-spective, single-centre, descriptive study. Lancet Infect Dis, doi: org/10.1016/S1473-3099(20)30176-6.
24. Wang X, Zhou Z, Zhang J et al (2020). A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery. Clin Infect Dis, ciaa200.
25. Li Y, Zhao R, Zheng S et al (2020). Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerg Infect Dis, 26(6).
26. Zeng L, Xia S, Yuan W et al (2020). Neona-tal Early-Onset Infection with SARS-CoV-2 in 33 Neonates Born to Mothers with COVID-19 in Wuhan, China. JA-MA Pediatr, doi: 10.1001/jamapediatrics.2020.0878.
27. Zhu H, Wang L, Fang C et al (2020). Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pedi-atr, 9(1): 51-60.
28. Zhang L, Jiang Y, Wei M et al (2020). Analy-sis of the pregnancy outcomes in preg-nant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi, 55(0): E009.
29. Liu D, Li L, Wu X et al (2020). Pregnancy and Perinatal Outcomes of Women with Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol, doi: 10.2214/AJR.20.23072.
30. Wang S, Guo L, Chen L et al (2020). A case report of neonatal COVID-19 infection in China. Clin Infect Dis, ciaa225.
31. Park MH, Kim HR, Choi DH, Sung JH, Kim JH (2016). Emergency cesarean sec-tion in an epidemic of the middle east respiratory syndrome: a case report. Kore-an J Anesthesiol, 69(3):287-91.
32. Robertson CA, Lowther SA, Birch T et al (2004). SARS and pregnancy: a case re-port. Emerg Infect Dis, 10(2):345-48.
33. Qi H, Chen D, Feng L, Zou L, Li J (2020). Obstetric considerations on delivery is-sues for pregnant women with COVID-19 infection. Chin J Obstet Gynecol, 55(02): E001.
34. Chen R, Zhang Y, Huang L et al (2020). Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case se-ries of 17 patients. Can J Anaesth, doi: 10.1007/s12630-020-01630-7.
35. Poon LC, Yang H, Lee JC et al (2020). ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol, doi: 10.1002/uog.22013.
36. Li A, Ng P (2005). Severe acute respiratory syndrome (SARS) in neonates and chil-dren. Arch Dis Child Fetal Neonatal Ed, 90(6): F461-F465.
37. Chen Y-H, Keller J, Wang I-T, Lin C-C, Lin H-C (2012). Pneumonia and pregnancy outcomes: a nationwide population-based study. Am J Obstet Gynecol, 207(4): e1-288.e7.
38. Guan W-j, Ni Z-y, Hu Y et al (2020). Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, doi: 10.1056/NEJMoa2002032.
39. Lam CM, Wong SF, Leung TN et al (2004). A case‐controlled study comparing clini-cal course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome. BJOG, 111(8):771-4.
40. Dior UP, Kogan L, Eventov-Friedman S et al (2016). Very high intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes. Neonatology, 109(1):62-8.
41. Mullins E, Evans D, Viner R, O'Brien P, Morris E (2020). Coronavirus in Preg-nancy and Delivery: Rapid Review. Ultra-sound Obstet Gynecol, doi: org/10.1002/uog.22014.
42. Assiri A, Abedi GR, Al Masri M et al (2016). Middle East Respiratory Syndrome Coronavirus Infection During Pregnancy: A Report of 5 Cases from Saudi Arabia. Clin Infect Dis, 63(7):951-3.
43. Rashidi Fakari F, Simbar M et al (2020). Ex-plaining the quality index of obstetric tri-age. Hayat, 25 (4):356-65.
44. Nalivaeva NN, Turner AJ, Zhuravin IA (2018). Role of Prenatal Hypoxia in Brain Development, Cognitive Functions, and Neurodegeneration. Front Neurosci, 12: 825.
45. World Health Organization (2020). Clinical management of severe acute respiratory infection (SARI) when COVID-19 dis-ease is suspected interim guidance. Avail-able from: https://www.who.int
46. Beau AB, Hurault‐Delarue C, Vial T et al (2014). Safety of oseltamivir during preg-nancy: a comparative study using the EFEMERIS database. BJOG, 121(7):895-900.
2. Song Z, Xu Y, Bao L et al (2019). From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses, 11(1): 59.
3. Wu F, Zhao S, Yu B et al (2020). A new coronavirus associated with human res-piratory disease in China. Nature, 579(7798): 265-9.
4. Rokni M, Ghasemi V, Tavakoli Z (2020). Immune responses and pathogenesis of SARS‐CoV‐2 during an outbreak in Iran: Comparison with SARS and MERS. Rev Med Virol, I doi:org/10.1002/rmv.2107.
5. Schwartz DA, Graham AL (2020). Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infect-ing Pregnant Women: Lessons from SARS, MERS, and Other Human Coro-navirus Infections. Viruses, 12(2): 1-16.
6. Liu Y, Chen H, Tang K, Guo Y (2020). Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect,S0163-4453(20)30109-2.
7. Liu H, Wang L-L, Zhao S-J et al (2020). Why are pregnant women susceptible to viral infection: an immunological view-point? J Reprod Immunol, 139:103122.
8. Ramsey PS, Ramin KD (2001). Pneumonia in pregnancy. Obstet Gynecol Clin North Am, 28(3): 553-69.
9. Dashe JS, Bloom SL, Spong CY, Hoffman BL (2018). Williams obstetrics: McGraw Hill Professional, USA, PP: 70-72.
10. Alserehi H, Wali G, Alshukairi A, Alraddadi B (2016). Impact of Middle East Respira-tory Syndrome coronavirus (MERS‐CoV) on pregnancy and perinatal outcome. BMC Infect Dis, 16: 105.
11. Wong SF, Chow KM, Leung TN et al (2004). Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol, 191(1): 292-7.
12. Wong S, Chow K, de Swiet M (2003). Severe acute respiratory syndrome and pregnan-cy. BJOG, 110(7): 641-2.
13. Chen SH, Huang B, Luo DJ et al (2020). Pregnant women with new coronavirus infection: a clinical characteristics and pla-cental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi, 49(0): E005.
14. Chen S, Liao E, Shao Y (2020). Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Vi-rol, doi: 10.1002/jmv.25789.
15. Fan C, Lei D, Fang C, Li C et al (2020). Per-inatal Transmission of COVID-19 Asso-ciated SARS-CoV-2: Should We Worry? Clin Infect Dis, doi: 10.1093/cid/ciaa226.
16. Khan S, Peng L, Siddique R et al (2020). Im-pact of COVID-19 infection on preg-nancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infect Control Hosp Epidemiol, 1-3.
17. Panahi L, Amiri M, Pouy S (2020). Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review. Arch Acad Emerg Med, 8(1): e34.
18. Luchini C, Stubbs B, Solmi M, Veronese N (2017). Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World J Metaanal, 5(4):80-4.
19. Kanthraj G, Srinivas C (2005). Journal Club: screen, select, probe & evaluate. Indian J Dermatol Venereol Leprol, 71(6):435-40.
20. Chen H, Guo J, Wang C et al (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 in-fection in nine pregnant women: a retro-spective review of medical records. Lancet, 395(10226):809-15.
21. Song L, Xiao W, Ling K, Yao S, Chen X (2020). Anesthetic Management for Emergent Cesarean Delivery in a Parturi-ent with Recent Diagnosis of Corona-virus Disease 2019 (COVID-19): A Case Report. Transl Perioper & Pain, 7(3): 234-237.
22. Chen Y, Peng H, Wang L et al (2020). In-fants born to mothers with a new coro-navirus (COVID-19). Front Pediatr, 8:1-5.
23. Yu N, Li W, Kang Q et al (2020). Clinical features and obstetric and neonatal out-comes of pregnant patients with COVID-19 in Wuhan, China: a retro-spective, single-centre, descriptive study. Lancet Infect Dis, doi: org/10.1016/S1473-3099(20)30176-6.
24. Wang X, Zhou Z, Zhang J et al (2020). A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery. Clin Infect Dis, ciaa200.
25. Li Y, Zhao R, Zheng S et al (2020). Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerg Infect Dis, 26(6).
26. Zeng L, Xia S, Yuan W et al (2020). Neona-tal Early-Onset Infection with SARS-CoV-2 in 33 Neonates Born to Mothers with COVID-19 in Wuhan, China. JA-MA Pediatr, doi: 10.1001/jamapediatrics.2020.0878.
27. Zhu H, Wang L, Fang C et al (2020). Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pedi-atr, 9(1): 51-60.
28. Zhang L, Jiang Y, Wei M et al (2020). Analy-sis of the pregnancy outcomes in preg-nant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi, 55(0): E009.
29. Liu D, Li L, Wu X et al (2020). Pregnancy and Perinatal Outcomes of Women with Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol, doi: 10.2214/AJR.20.23072.
30. Wang S, Guo L, Chen L et al (2020). A case report of neonatal COVID-19 infection in China. Clin Infect Dis, ciaa225.
31. Park MH, Kim HR, Choi DH, Sung JH, Kim JH (2016). Emergency cesarean sec-tion in an epidemic of the middle east respiratory syndrome: a case report. Kore-an J Anesthesiol, 69(3):287-91.
32. Robertson CA, Lowther SA, Birch T et al (2004). SARS and pregnancy: a case re-port. Emerg Infect Dis, 10(2):345-48.
33. Qi H, Chen D, Feng L, Zou L, Li J (2020). Obstetric considerations on delivery is-sues for pregnant women with COVID-19 infection. Chin J Obstet Gynecol, 55(02): E001.
34. Chen R, Zhang Y, Huang L et al (2020). Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case se-ries of 17 patients. Can J Anaesth, doi: 10.1007/s12630-020-01630-7.
35. Poon LC, Yang H, Lee JC et al (2020). ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol, doi: 10.1002/uog.22013.
36. Li A, Ng P (2005). Severe acute respiratory syndrome (SARS) in neonates and chil-dren. Arch Dis Child Fetal Neonatal Ed, 90(6): F461-F465.
37. Chen Y-H, Keller J, Wang I-T, Lin C-C, Lin H-C (2012). Pneumonia and pregnancy outcomes: a nationwide population-based study. Am J Obstet Gynecol, 207(4): e1-288.e7.
38. Guan W-j, Ni Z-y, Hu Y et al (2020). Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, doi: 10.1056/NEJMoa2002032.
39. Lam CM, Wong SF, Leung TN et al (2004). A case‐controlled study comparing clini-cal course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome. BJOG, 111(8):771-4.
40. Dior UP, Kogan L, Eventov-Friedman S et al (2016). Very high intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes. Neonatology, 109(1):62-8.
41. Mullins E, Evans D, Viner R, O'Brien P, Morris E (2020). Coronavirus in Preg-nancy and Delivery: Rapid Review. Ultra-sound Obstet Gynecol, doi: org/10.1002/uog.22014.
42. Assiri A, Abedi GR, Al Masri M et al (2016). Middle East Respiratory Syndrome Coronavirus Infection During Pregnancy: A Report of 5 Cases from Saudi Arabia. Clin Infect Dis, 63(7):951-3.
43. Rashidi Fakari F, Simbar M et al (2020). Ex-plaining the quality index of obstetric tri-age. Hayat, 25 (4):356-65.
44. Nalivaeva NN, Turner AJ, Zhuravin IA (2018). Role of Prenatal Hypoxia in Brain Development, Cognitive Functions, and Neurodegeneration. Front Neurosci, 12: 825.
45. World Health Organization (2020). Clinical management of severe acute respiratory infection (SARI) when COVID-19 dis-ease is suspected interim guidance. Avail-able from: https://www.who.int
46. Beau AB, Hurault‐Delarue C, Vial T et al (2014). Safety of oseltamivir during preg-nancy: a comparative study using the EFEMERIS database. BJOG, 121(7):895-900.
| Files | ||
| Issue | Vol 49 No Supple 1 (2020) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v49iS1.3668 | |
| Keywords | ||
| Pregnancy Neonate Outcome Coronavirus infection COVID-19 | ||
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How to Cite
1.
BANAEI M, GHASEMI V, SAEI GHARE NAZ M, KIANI Z, RASHIDI-FAKARI F, BANAEI S, MOHAMMAD SOURI B, ROKNI M. Obstetrics and Neonatal Outcomes in Pregnant Women with COVID-19: A Systematic Review. Iran J Public Health. 2020;49(Supple 1):38-47.
