Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
Department of Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Eur J Obstet Gynecol Reprod Biol. 2021 Jan;256:194-204. doi: 10.1016/j.ejogrb.2020.11.038. Epub 2020 Nov 13.
Evidence concerning coronavirus disease-19 (covid-19) in pregnancy is still scarce and scattered. This meta-analysis aims to evaluate maternal and neonatal outcomes in covid-19 pregnancies and identify factors associated with perinatal viral transmission. Medline, Scopus, CENTRAL, Web of Science and Google Scholar databases were systematically searched to 3 June 2020. Overall, 16 observational studies and 44 case reports/series were included. Fever was the most frequent maternal symptom, followed by cough and shortness of breath, while about 15 % of infected were asymptomatic. Severe disease was estimated to occur in 11 % of women in case reports/series and in 7 % (95 % CI: 4 %-10 %) in observational studies. Two maternal deaths were reported. The rate of neonatal transmission did not differ between women with and without severe disease (OR: 1.94, 95 % CI: 0.50-7.60). Preterm birth occurred in 29.7 % and 16 % (95 % CI: 11 %-21 %) in data obtained from case series and observational studies, respectively. Stillbirth occurred in 3 cases and 2 neonatal deaths were observed. Vertical transmission was suspected in 4 cases. Fever was the most common neonatal symptom (40 %), followed by shortness of breath (28 %) and vomiting (24 %), while 20 % of neonates were totally asymptomatic. In conclusion, the maternal and neonatal clinical course the infection is typically mild, presenting low mortality rates. The risk of vertical transmission is suggested to be low and may not be affected by the severity of maternal disease. Further large-scale studies are needed to clarify the risk factors associated with viral transmission and severe infection in the neonatal population.
关于新型冠状病毒疾病（COVID-19）在妊娠中的证据仍然很少且分散。本荟萃分析旨在评估 COVID-19 妊娠中的母婴结局，并确定与围产期病毒传播相关的因素。系统检索了 Medline、Scopus、CENTRAL、Web of Science 和 Google Scholar 数据库，检索时间截至 2020 年 6 月 3 日。共纳入 16 项观察性研究和 44 例病例报告/系列。发热是最常见的母体症状，其次是咳嗽和呼吸急促，而约 15%的感染者无症状。病例报告/系列中估计有 11%的妇女患有严重疾病，观察性研究中为 7%（95%CI：4%-10%）。报告了 2 例产妇死亡。严重疾病组与非严重疾病组新生儿传播率无差异（OR：1.94，95%CI：0.50-7.60）。病例系列和观察性研究分别获得的数据显示，早产发生率分别为 29.7%和 16%（95%CI：11%-21%）。发生了 3 例死产，2 例新生儿死亡。怀疑有 4 例垂直传播。发热是最常见的新生儿症状（40%），其次是呼吸急促（28%）和呕吐（24%），而 20%的新生儿完全无症状。总之，感染的母婴临床过程通常较轻，死亡率较低。垂直传播的风险较低，可能不受母体疾病严重程度的影响。需要进一步的大规模研究来阐明与新生儿人群中病毒传播和严重感染相关的危险因素。
