Department of Medicine, St George's, University of London, London, United Kingdom.
Faculty of Medicine, Imperial College London, London, United Kingdom.
Gynecol Obstet Invest. 2020;85(4):295-306. doi: 10.1159/000509290. Epub 2020 Jul 30.
To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner.
A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale.
Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%).
COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers.
系统回顾与 2019 年冠状病毒病（COVID-19）大流行期间严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染相关的妊娠、胎儿和新生儿结局的已发表研究。
通过 PubMed、Scopus、Medline、Cochrane 数据库和 Google Scholar 进行全面的电子检索，检索时间为 2019 年 12 月 1 日至 2020 年 5 月 22 日，并查阅了所有纳入研究的参考文献列表。纳入了所有报告 COVID-19 期间妊娠结局的队列研究。使用纽卡斯尔-渥太华量表对纳入研究进行定性评估。
大多数孕妇在入院时接受了低剂量辐射 CT 扫描；报告显示大多数患者存在单侧/双侧肺炎。许多 COVID-19 患者还出现明显的淋巴细胞减少症。筛选出 513 个标题，纳入了 22 项研究，其中包括 156 例 COVID-19 孕妇和 108 例新生儿结局。最常见的母体/胎儿并发症包括宫内/胎儿窘迫（14%）和胎膜早破（8%）。COVID-19 新生儿的临床表现常见为呼吸急促（6%）、胃肠道症状（4%）和发热（3%）。
COVID-19 感染妊娠会增加早产、胎膜早破等妊娠并发症的风险，在极少数情况下可能导致母亲死亡。目前尚无证据支持 SARS-CoV-2 感染垂直传播给胎儿。由于关于 COVID-19 对新生儿影响的数据不一致且数量较少，应谨慎进一步调查和监测 COVID-19 感染母亲所生新生儿可能的感染。
