COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases.
Por:
Abou Ghayda R, Li H, Lee KH, Lee HW, Hong SH, Kwak M, Lee M, Kwon M, Koyanagi A, Kronbichler A, Jacob L, Smith L and Shin JI
Publicada:
26 oct 2020
Ahead of Print:
26 oct 2020
Categoría:
Medicine (miscellaneous)
Resumen:
(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.
Filiaciones:
Abou Ghayda R:
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Division of Urology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA
Li H:
Department of Molecular Genetics and Microbiology, Center for Neurogenetics and the Genetics Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA
Lee KH:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Lee HW:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Hong SH:
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Kwak M:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Lee M:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Kwon M:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
Kronbichler A:
Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, 6020 Innsbruck, Austria
Jacob L:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, 78180 Versailles, France
Smith L:
The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
Shin JI:
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Green Published, Green Accepted, gold
|