Clinical Characteristics and Neonatal Outcomes of Pregnant Patients With COVID-19: A Systematic Review

Islam, M.M. and Poly, T.N. and Walther, B.A. and Yang, H.C. and Wang, C.-W. and Hsieh, W.-S. and Atique, S. and Salmani, H. and Alsinglawi, B. and Lin, M.C. and Jian, W.S. and Jack Li, Y.-C. (2020) Clinical Characteristics and Neonatal Outcomes of Pregnant Patients With COVID-19: A Systematic Review. Frontiers in Medicine, 7.

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Abstract

Background and Objective: Coronavirus disease 2019 (COVID-19) characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created serious concerns about its potential adverse effects. There are limited data on clinical, radiological, and neonatal outcomes of pregnant women with COVID-19 pneumonia. This study aimed to assess clinical manifestations and neonatal outcomes of pregnant women with COVID-19. Methods: We conducted a systematic article search of PubMed, EMBASE, Scopus, Google Scholar, and Web of Science for studies that discussed pregnant patients with confirmed COVID-19 between January 1, 2020, and April 20, 2020, with no restriction on language. Articles were independently evaluated by two expert authors. We included all retrospective studies that reported the clinical features and outcomes of pregnant patients with COVID-19. Results: Forty-seven articles were assessed for eligibility; 13 articles met the inclusion criteria for the systematic review. Data is reported for 235 pregnant women with COVID-19. The age range of patients was 25�40 years, and the gestational age ranged from 8 to 40 weeks plus 6 days. Clinical characteristics were fever 138/235 (58.72%), cough 111/235 (47.23%), and sore throat 21/235 (8.93%). One hundred fifty six out of 235 (66.38%) pregnant women had cesarean section, and 79 (33.62%) had a vaginal delivery. All the patients showed lung abnormalities in CT scan images, and none of the patients died. Neutrophil cell count, C-reactive protein (CRP) concentration, ALT, and AST were increased but lymphocyte count and albumin levels were decreased. Amniotic fluid, neonatal throat swab, and breastmilk samples were taken to test for SARS-CoV-2 but all found negativ results. Recent published evidence showed the possibility of vertical transmission up to 30%, and neonatal death up to 2.5%. Pre-eclampsia, fetal distress, PROM, pre-mature delivery were the major complications of pregnant women with COVID-19. Conclusions: Our study findings show that the clinical, laboratory and radiological characteristics of pregnant women with COVID-19 were similar to those of the general populations. The possibility of vertical transmission cannot be ignored but C-section should not be routinely recommended anymore according to latest evidences and, in any case, decisions should be taken after proper discussion with the family. Future studies are needed to confirm or refute these findings with a larger number of sample sizes and a long-term follow-up period. © Copyright © 2020 Islam, Poly, Walther, Yang, Wang, Hsieh, Atique, Salmani, Alsinglawi, Lin, Jian and Jack Li.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: alanine aminotransferase; albumin; alkaline phosphatase; aspartate aminotransferase; C reactive protein; lactate dehydrogenase, adult; alanine aminotransferase blood level; albumin blood level; alkaline phosphatase blood level; amnion fluid; Apgar score; aspartate aminotransferase blood level; birth weight; breast milk; cephalopelvic disproportion; cesarean section; clinical feature; comparative study; controlled study; coronavirus disease 2019; coughing; diarrhea; dyspnea; fatigue; female; fetus distress; fever; gestational age; human; hypothyroidism; influenza; lactate dehydrogenase blood level; leukocyte count; low birth weight; lymphocyte count; lymphocytopenia; malaise; maternal hypertension; myalgia; neutrophil count; newborn; newborn anemia; newborn death; pleura effusion; preeclampsia; pregnancy complication; pregnancy diabetes mellitus; pregnancy outcome; pregnant woman; premature fetus membrane rupture; prematurity; retrospective study; Review; rigor; scar formation; solutio placentae; sore throat; sputum; systematic review; thorax pain; thorax radiography; throat culture; throat swab; vaginal delivery; vertical transmission; virus pneumonia; x-ray computed tomography
Subjects: WC Communicable Diseases
WS Pediatrics
Depositing User: eprints admin
Date Deposited: 26 Apr 2021 09:16
Last Modified: 26 Apr 2021 09:16
URI: http://eprints.iums.ac.ir/id/eprint/33417

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