COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes
- PMID: 34185807
- PMCID: PMC8241118
- DOI: 10.1371/journal.pone.0253974
COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes
Abstract
Background: We conducted an overview of systematic reviews (SRs) summarizing the best evidence regarding the effect of COVID-19 on maternal and child health following Cochrane methods and PRISMA statement for reporting (PROSPERO-CRD42020208783).
Methods: We searched literature databases and COVID-19 research websites from January to October 2020. We selected relevant SRs reporting adequate search strategy, data synthesis, risk of bias assessment, and/or individual description of included studies describing COVID-19 and pregnancy outcomes. Pair of reviewers independently selected studies through COVIDENCE web-software, performed the data extraction, and assessed its quality through the AMSTAR-2 tool. Discrepancies were resolved by consensus. Each SR's results were synthesized and for the most recent, relevant, comprehensive, and with the highest quality, by predefined criteria, we presented GRADE evidence tables.
Results: We included 66 SRs of observational studies out of 608 references retrieved and most (61/66) had "critically low" overall quality. We found a relatively low degree of primary study overlap across SRs. The most frequent COVID-19 clinical findings during pregnancy were fever (28-100%), mild respiratory symptoms (20-79%), raised C-reactive protein (28-96%), lymphopenia (34-80%), and pneumonia signs in diagnostic imaging (7-99%). The most frequent maternal outcomes were C-section (23-96%) and preterm delivery (14-64%). Most of their babies were asymptomatic (16-93%) or presented fever (0-50%), low birth weight (5-43%) or preterm delivery (2-69%). The odds ratio (OR) of receiving invasive ventilation for COVID-19 versus non-COVID-19 pregnant women was 1.88 (95% Confidence Interval [CI] 1.36-2.60) and the OR that their babies were admitted to neonatal intensive care unit was 3.13 (95%CI 2.05-4.78). The risk of congenital transmission or via breast milk was estimated to be low, but close contacts may carry risks.
Conclusion: This comprehensive overview supports that pregnant women with COVID-19 may be at increased risk of adverse pregnancy and birth outcomes and low risk of congenital transmission.
Conflict of interest statement
The authors have declared that no competing interests exist.
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References
-
- National COVID-19 Clinical Evidence Taskforce. Australian guidelines for the clinical care of people with COVID-19. 2020. [version 33]. 2020 [01/23/2021]. Available from: https://covid19evidence.net.au/.
-
- Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al.. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ (Clinical research ed). 2020;370:m3320. doi: 10.1136/bmj.m3320 - DOI - PMC - PubMed
-
- WHO. Coronavirus disease (COVID-19): Pregnancy and childbirth: WHO; 2021. [cited 2021 16 April 2021]. Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-pr....
-
- Pollock M, Fernandes RM, Becker LA, Pieper D, L. H. Chapter V: Overviews of Reviews. 2019. In: Cochrane Handbook for Systematic Reviews of Interventions version 60 (updated July 2019) [Internet]. Cochrane. Available from: Available from www.training.cochrane.org/handbook.
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