Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Arch Gynecol Obstet. 2021 Jul;304(1):5-38. doi: 10.1007/s00404-021-06049-z. Epub 2021 Apr 2.
In December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan, China, with an incredible contagion rate. However, the vertical transmission of COVID-19 is uncertain.
This is a systematic review of published studies concerning pregnant women with confirmed COVID-19 and their neonates.
We carried out a systematic search in multiple databases, including PubMed, Web of Science, Google Scholar, Scopus, and WHO COVID-19 database using the following keywords: (Coronavirus) OR (novel coronavirus) OR (COVID-19) OR (COVID19) OR (COVID 19) OR (SARS-CoV2) OR (2019-nCoV)) and ((pregnancy) OR (pregnant) OR (vertical transmission) OR (neonate) OR (newborn) OR (placenta) OR (fetus) OR (Fetal)). The search took place in April 2020.
Original articles published in English were eligible if they included pregnant patients infected with COVID-19 and their newborns.
The outcomes of interest consisted of clinical manifestations of COVID-19 in pregnant patients with COVID-19 and also the effect of COVID-19 on neonatal and pregnancy outcomes.
37 articles involving 364 pregnant women with COVID-19 and 302 neonates were included. The vast majority of pregnant patients were in their third trimester of pregnancy, and only 45 cases were in the first or second trimester (12.4%). Most mothers described mild to moderate manifestations of COVID-19. Of 364 pregnant women, 25 were asymptomatic at the time of admission. The most common symptoms were fever (62.4%) and cough (45.3%). Two maternal deaths occurred. Some pregnant patients (12.1%) had a negative SARS-CoV-2 test but displayed clinical manifestations and abnormalities in computed tomography (CT) scan related to COVID-19. Twenty-two (6.0%) pregnant patients developed severe pneumonia. Two maternal deaths occurred from severe pneumonia and multiple organ dysfunction. Studies included a total of 302 neonates from mothers with COVID-19. Of the studies that provided data on the timing of birth, there were 65 (23.6%) preterm neonates. One baby was born dead from a mother who also died from COVID-19. Of the babies born alive from mothers with COVID-19, five newborns faced critical conditions, and two later died. A total of 219 neonates underwent nasopharyngeal specimen collection for SARS-CoV-2, of which 11 tested positive (5%). Seventeen studies examined samples of the placenta, breast milk, umbilical cord, and amniotic fluid, and all tested negative except one amniotic fluid sample.
A systematic review of published studies confirm that the course of COVID-19 in pregnant women resembles that of other populations. However, there is not sufficient evidence to establish an idea that COVID-19 would not complicate pregnancy.
2019 年 12 月，一种新型冠状病毒疾病（COVID-19）在中国武汉出现，其传染性令人难以置信。然而，COVID-19 的垂直传播尚不确定。
这是对已确诊 COVID-19 的孕妇及其新生儿进行的系统评价。
我们在多个数据库中进行了系统搜索，包括 PubMed、Web of Science、Google Scholar、Scopus 和世界卫生组织 COVID-19 数据库，使用了以下关键词：（冠状病毒）或（新型冠状病毒）或（COVID-19）或（COVID19）或（COVID-19）或（SARS-CoV2）或（2019-nCoV））和（（怀孕）或（孕妇）或（垂直传播）或（新生儿）或（新生儿）或（胎盘）或（胎儿）或（胎儿））。搜索于 2020 年 4 月进行。
如果原始文章发表于英语，且包含感染 COVID-19 的孕妇及其新生儿，则符合条件。
感兴趣的结果包括患有 COVID-19 的孕妇的 COVID-19 临床表现以及 COVID-19 对新生儿和妊娠结局的影响。
纳入了 37 篇涉及 364 名 COVID-19 孕妇和 302 名新生儿的文章。绝大多数孕妇处于妊娠晚期，只有 45 例处于第一或第二孕期（12.4%）。大多数母亲描述了 COVID-19 的轻度至中度表现。364 名孕妇中，25 名在入院时无症状。最常见的症状是发烧（62.4%）和咳嗽（45.3%）。有 2 例孕妇死亡。一些孕妇（12.1%）的 SARS-CoV-2 检测呈阴性，但出现与 COVID-19 相关的临床症状和计算机断层扫描（CT）扫描异常。22 名（6.0%）孕妇发生严重肺炎。2 例孕妇因严重肺炎和多器官功能障碍而死亡。研究共纳入 302 名来自 COVID-19 母亲的新生儿。在提供分娩时间数据的研究中，有 65 名（23.6%）早产儿。一名婴儿出生时死亡，母亲也死于 COVID-19。在出生时来自 COVID-19 母亲的存活婴儿中，有 5 名新生儿情况危急，其中 2 名后来死亡。共有 219 名新生儿采集鼻咽拭子进行 SARS-CoV-2 检测，其中 11 例呈阳性（5%）。有 17 项研究检测了胎盘、母乳、脐带和羊水样本，除了一份羊水样本外，其余均为阴性。
对已发表研究的系统评价证实，COVID-19 在孕妇中的病程与其他人群相似。然而，尚无足够证据表明 COVID-19 不会使妊娠复杂化。
