Behavioral Sciences Research Center, Lifestyle Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.
J Pregnancy. 2021 Mar 5;2021:8870129. doi: 10.1155/2021/8870129. eCollection 2021.
Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19.
Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions.
117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term.
COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women.
根据目前所知，与非孕妇相比，孕妇感染 COVID-19 后病重的风险增加。此外，患有 COVID-19 的孕妇可能有不良妊娠结局的风险增加。为了研究 2019 年冠状病毒病（COVID-19）对孕妇和产后妇女死亡率的影响，我们对 COVID-19 感染孕妇的现有已发表文献进行了系统评价。
检索了 Web of Science、SCOPUS 和 MEDLINE-数据库，以获取截至 2020 年 7 月 10 日发表的关于 COVID-19 对孕妇和产后妇女死亡率影响的原始研究。使用比例的荟萃分析来合并数据并报告汇总比例。
共纳入 117 项研究，共计 11758 例孕妇。年龄在 15 至 48 岁之间。大多数患者在妊娠晚期感染 SARS-CoV-2。1125 例患者未报告疾病严重程度。孕产妇死亡率为 1.3%。在有足够数据的所有致命病例中，发热伴或不伴咳嗽是其中一种首发症状。此外，呼吸困难（58.3%）和肌痛（50%）是最常见的症状。咽痛（8.3%）和胃肠道症状（厌食、恶心）（8.3%）很少见。COVID-19 死亡患者的合并症发生率为 20%。大多数死于 COVID-19 的感染孕妇行剖宫产术（58.3%），25%行阴道分娩，16.7%的患者未足月。
孕妇感染 COVID-19 与更高的剖宫产率和死亡率（和汇总比例）相关。由于新数据不断生成和发表，本研究的结果可以通过新的研究进行完善和更新。本研究结果可以指导和改善 COVID-19 感染孕妇的产前咨询。
