Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, Hubei, China.
Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Arch Gynecol Obstet. 2021 Feb;303(2):337-345. doi: 10.1007/s00404-020-05889-5. Epub 2020 Dec 1.
This systematic review summarizes the clinical features and maternal-infant outcomes of 230 pregnant women (154 patients gave birth) infected with COVID-19 and their 156 infants, including the possibility and evidence of vertical transmission.
An electronic search of PubMed, Embase, Medline, MedRxiv, CNKI, and the Chinese Medical Journal Full Text Database following PRISMA guidelines was performed through April 18, 2020. Search terms included COVID-19, SARS-CoV-2, pregnant women, infants, and vertical transmission.
A total of 230 women with COVID-19 (154 deliveries, 66 ongoing pregnancies, and 10 abortions) and 156 newborns from 20 eligible studies were included in this systematic review. A total of 34.62% of the pregnant patients had obstetric complications, and 59.05% of patients displayed fever. Lymphopenia was observed in 40.71% of patients. A total of 5.19% of women received mechanical ventilation. Seven women were critically ill. One mother and two newborns died. A total of 24.74% of newborns were premature. Five newborns' throat swab tests of SARS-CoV-2 were positive, all of which were delivered by cesarean section. For eight newborns with negative throat swab tests, three had both elevated IgM and IgG against SARS-CoV-2. Nucleic acid tests of vaginal secretions, breast milk, amniotic fluid, placental blood, and placental tissues were negative.
Most pregnant patients were mildly ill. The mortality of pregnant women with COVID-19 was lower than that of overall COVID-19 patients. Cesarean section was more common than vaginal delivery for pregnant women with COVID-19. Premature delivery was the main adverse event for newborns. The vertical transmission rate calculated by SARS-CoV-2 nucleic acid tests was 3.91%. Serum antibodies against SARS-CoV-2 should be tested more frequently, and multiple samples should be included in pathogenic testing.
本系统综述总结了 230 名感染 COVID-19 的孕妇（154 名患者分娩）及其 156 名婴儿的临床特征和母婴结局，包括垂直传播的可能性和证据。
根据 PRISMA 指南，通过电子检索 PubMed、Embase、Medline、MedRxiv、CNKI 和中国医学期刊全文数据库，检索时间截至 2020 年 4 月 18 日。检索词包括 COVID-19、SARS-CoV-2、孕妇、婴儿和垂直传播。
本系统综述共纳入 20 项研究的 230 名感染 COVID-19 的孕妇（154 例分娩，66 例持续妊娠，10 例流产）及其 156 名新生儿。共有 34.62%的孕妇发生产科并发症，59.05%的孕妇发热。40.71%的患者出现淋巴细胞减少。共有 5.19%的孕妇接受机械通气。7 名孕妇病重。1 名母亲和 2 名新生儿死亡。共有 24.74%的新生儿早产。5 名新生儿的 SARS-CoV-2 咽拭子检测呈阳性，均行剖宫产分娩。8 名咽拭子检测阴性的新生儿中，有 3 名 SARS-CoV-2 的 IgM 和 IgG 均升高。阴道分泌物、母乳、羊水、胎盘血和胎盘组织的核酸检测均为阴性。
大多数孕妇病情较轻。COVID-19 孕妇的死亡率低于总体 COVID-19 患者。COVID-19 孕妇更常行剖宫产分娩而非阴道分娩。新生儿早产是主要不良事件。通过 SARS-CoV-2 核酸检测计算的垂直传播率为 3.91%。应更频繁地检测 SARS-CoV-2 血清抗体，并在病原体检测中纳入多个样本。
