Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

BMJ, Journal Year: 2020, Volume and Issue: unknown, P. m3320 - m3320

Published: Sept. 1, 2020

Abstract Objective To determine the clinical manifestations, risk factors, and maternal perinatal outcomes in pregnant recently women with suspected or confirmed coronavirus disease 2019 (covid-19). Design Living systematic review meta-analysis. Data sources Medline, Embase, Cochrane database, WHO COVID-19 China National Knowledge Infrastructure (CNKI), Wanfang databases from 1 December to 27 April 2021, along preprint servers, social media, reference lists. Study selection Cohort studies reporting rates, manifestations (symptoms, laboratory radiological findings), covid-19. extraction At least two researchers independently extracted data assessed study quality. Random effects meta-analysis was performed, estimates pooled as odds ratios difference proportions 95% confidence intervals. All analyses are updated regularly. Results 435 were included. Overall, 9% (95% interval 7% 10%; 149 studies, 926 232 women) of attending admitted hospital for any reason diagnosed having The most common covid-19 pregnancy fever cough (both 36%). Compared non-pregnant reproductive age, less likely report symptoms fever, dyspnoea, cough, myalgia. admission an intensive care unit (odds ratio 2.61, 1.84 3.71; I 2 =85.6%), invasive ventilation (2.41, 2.13 2.71; =0%) higher than age. 970 (0.2%, 123 179 981 died cause. In covid-19, non-white ethnicity, increased high body mass index, pre-existing comorbidity including chronic hypertension diabetes, specific complications such gestational diabetes pre-eclampsia, associated serious (severe unit, ventilation, death). without those had death 6.09, 1.82 20.38; =76.6%), (5.41, 3.59 8.14; =57.0%), caesarean section (1.17, 1.01 1.36; =80.3%), preterm birth (1.57, 1.36 1.81; =49.3%). stillbirth (1.81, 1.38 2.37, =0%), neonatal (2.18, 1.46 3.26, =85.4%) babies born versus Conclusion Pregnant hospitals manifest myalgia, but more be needing Pre-existing comorbidities, hypertension, index factors severe pregnancy. deliver have being unit. Their Systematic registration PROSPERO CRD42020178076. Readers’ note This article is a living that will reflect emerging evidence. Updates may occur up years date original publication. version update published on September 2020 ( BMJ 2020;370:m3320), previous updates can found supplements https://www.bmj.com/content/370/bmj.m3320/related#datasupp ). When citing this paper please consider adding number access clarity.

Language: Английский

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The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate

Nature Immunology, Journal Year: 2021, Volume and Issue: 22(12), P. 1490 - 1502

Published: Oct. 6, 2021

Language: Английский

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Differential impact of COVID‐19 in pregnant women from high‐income countries and low‐ to middle‐income countries: A systematic review and meta‐analysis

International Journal of Gynecology & Obstetrics, Journal Year: 2021, Volume and Issue: 155(1), P. 48 - 56

Published: June 23, 2021

Language: Английский

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SARS-CoV-2 and the subsequent development of preeclampsia and preterm birth: evidence of a dose-response relationship supporting causality

American Journal of Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 225(6), P. 689 - 693.e1

Published: Aug. 26, 2021

Pregnant women affected with a severe SARS-CoV-2 infection have worse clinical outcomes than nonpregnant SARS-CoV-2, which can include the greater risks for admission to intensive care unit, use of invasive mechanical ventilation, need extracorporeal membrane oxygenation, and death. In addition, is risk factor fetal death preterm birth. Early during COVID-19 pandemic, preeclampsia-like syndrome was reported in pregnant SARS-CoV-2.1Mendoza M. Garcia-Ruiz I. Maiz N. et al.Pre-eclampsia-like induced by COVID-19: prospective observational study.BJOG. 2020; 127: 1374-1380Google Scholar This association has been confirmed case series,2Metz T.D. Clifton R.G. Hughes B.L. al.Disease severity perinatal patients coronavirus disease 2019 (COVID-19).Obstet Gynecol. 2021; 137: 571-580Google systematic reviews, meta-analyses.3Conde-Agudelo A. Romero R. SARS-COV-2 pregnancy preeclampsia: review meta-analysis.Am J Obstet ([Epub ahead print])Google An important issue whether causes preeclampsia. One Bradford Hill criteria assess causality existence dose-response relationship between an exposure outcome interest, which, this case, likelihood study conducted address question. A retrospective based on data from 14 National Health Service (NHS) maternity hospitals United Kingdom effects pregnancy. The institutions are listed as footnote Supplemental Table. considered exempt Institutional Review Board NHS Research Authority. At each participating site, electronic patient records were reviewed identify cases diagnosis positive polymerase chain reaction test February 1, 2020 May 2021. maternal demographic characteristics, medical history, (ie, live birth or loss, gestational age at delivery, birthweight, hypertensive pregnancy, dates onset) obtained hospital databases. Individual relevant information about classified into 4 groups according modified spectrum used Institutes Health. follows: (1) asymptomatic—this group includes individuals who but no symptoms; (2) mild illness—includes any various signs symptoms (such fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss taste smell) do not shortness breath, dyspnea, abnormal chest imaging; (3) moderate show evidence lower respiratory assessment imaging oxygen saturation (SpO2) ≥94% room air; (4) require high dependency secondary impairment failure multiorgan dysfunction. primary occurrence preeclampsia exposed SARS-CoV-2. other examined delivery. Preeclampsia defined hypertension (blood pressure ≥140 mm Hg/≥90 Hg) developing after 20 weeks gestation previously normotensive woman chronic development new onset proteinuria (≥300 mg per 24 h protein creatinine ratio >30 mg/mmoL >2 + dipstick testing). effect (four factor: asymptomatic, mild, moderate, severe) rate assessed using robust Poisson regression models. Models fit geepack package R statistical language environment (www.r-project.org; Foundation, Vienna, Austria). asymptomatic reference, model included adjustment prior (log thereof), defined, characteristics history competing model.4Wright D. Syngelaki Akolekar Poon L.C. Nicolaides K.H. Competing screening history.Am 2015; 213: 62.e1-62.e10PubMed Google We compared combined against patients. (<37 weeks) evaluated while adjusting age, weight, height, race, method conception, hypertension, smoking, diabetes. selection these variables performed backward elimination. chi-square trend (n=1223) presented Of these, 51 (4.2%) had preeclampsia, 16 (1.3%) miscarriage, 215 (17.6%) birth; there 10 (0.81%) deaths. Women tended be older higher body mass index (P<.05 both) (Supplemental Table). 21 diagnosed before infection, 7 same 23 infection. removed further analysis. median interval among days (interquartile range, 7–61 days). Among 30 analysis, 13 17 term cohort comparable factors those population approximately 1% (Figure, A). observed excluding expected: 1.9% patients, 2.2% COVID-19, 5.7% disease, 11.1% monotonic statistically significant (chi-square trend; P=.0017). then (reference group) differences determined model. Severe associated (adjusted [RR], 4.9; 1.56–15.38). There RR, 3.3; 1.48–7.38). Because others proposed that predisposes we hypothesis within our dataset. analysis all developed SARS-Cov2 did develop found toward increased (unadjusted 2.28; 0.92–5.61) (P=.07), 1.96; 0.8–4.84) (P=.14). Moreover, excluded (n=1162) set. 11.7% 12.8% 29.9% 69.4% B). Similarly, function trend, P<.0001). Compared (moderate: adjusted 2.47, 1.61–3.78; severe: 5.64, 4.09–7.79). delivery C). mean significantly earlier (asymptomatic: 38.7, 37.5, 33 weeks, P<.001 both comparisons). (32 <37 weeks), very (28 <32 extreme (<28 P<.0001 each) D). principal finding here subsequent conclusion large number tested calculation individualized obstetrical history. Patients 5-fold relative 3.3-fold Notably, estimate 1.96 when testing reverse authors.5Papageorghiou A.T. Deruelle P. Gunier R.B. al.Preeclampsia results INTERCOVID longitudinal study.Am 225: 289.e1-289.e17PubMed Our findings consistent Metz al2Metz 1219 meta-analysis, symptomatic illness (odds [OR], 2.11; 95% confidence [CI], 1.59–2.81) more likely (OR, 1.59; CI, 1.21–2.10).3Conde-Agudelo

Language: Английский

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SARS-CoV-2 infection in the first trimester and the risk of early miscarriage: a UK population-based prospective cohort study of 3041 pregnancies conceived during the pandemic

Human Reproduction, Journal Year: 2022, Volume and Issue: 37(6), P. 1126 - 1133

Published: March 25, 2022

Does maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the first trimester affect risk of miscarriage before 13 week's gestation?

Language: Английский

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Timing and severity of COVID-19 during pregnancy and risk of preterm birth in the International Registry of Coronavirus Exposure in Pregnancy

BMC Pregnancy and Childbirth, Journal Year: 2022, Volume and Issue: 22(1)

Published: Oct. 18, 2022

Studies of preterm delivery after COVID-19 are often subject to selection bias and do not distinguish between early vs. late infection in pregnancy, nor spontaneous medically indicated delivery. This study aimed estimate the risk birth (overall, spontaneous, indicated) during while considering different levels disease severity timing.Pregnant recently pregnant people who were tested for or clinically diagnosed with pregnancy enrolled an international internet-based cohort June 2020 July 2021. We used several analytic approaches minimize confounding immortal time bias, including multivariable regression, time-to-delivery models, a case-time-control design.Among 14,264 eligible participants from 70 countries did report loss before 20 gestational weeks, 5893 had completed their pregnancies reported information; others censored at last follow-up. Participants symptomatic weeks' gestation no increased compared those testing negative, adjusted risks 10.0% (95% CI 7.8, 12.0) 9.8% (9.1, 10.5). Mild later was clearly associated In contrast, severe led increase milder disease. For example, ratio comparing mild/moderate 35 weeks 2.8 (2.0, 4.0); corresponding ratios 3.7 7.0) 2.3 (1.2, 3.9), respectively.Severe sharply COVID-19. elevated primarily due deliveries, included cesarean sections, although also observed. mild moderate conferred minimal risk, as pregnancy.

Language: Английский

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Adverse Perinatal Outcomes in COVID-19 Infected Pregnant Women: A Systematic Review and Meta-Analysis

Healthcare, Journal Year: 2022, Volume and Issue: 10(2), P. 203 - 203

Published: Jan. 20, 2022

The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on perinatal outcomes. Databases Medline, Embase, Cochrane library were searched using keywords related outcomes from December 2019 30 June 2021. Observational studies comparing in with a non-infected comparator included. screening process quality assessment included performed independently by two reviewers. Meta-analyses used comparative dichotomous data database search yielded 4049 results, 1254 which duplicates. We total 21 observational that assessed adverse infection. odds maternal death (pooled OR: 7.05 [2.41−20.65]), preeclampsia 1.39 [1.29−1.50]), cesarean delivery 1.67 [1.29−2.15]), fetal distress 1.66 [1.35−2.05]), preterm birth 1.86 [1.34−2.58]), low weight 1.69 [1.35−2.11]), stillbirth 1.46 [1.16−1.85]), 5th minute Apgar score less than 7 1.44 [1.11−1.86]) admissions neonatal intensive care unit 2.12 [1.36−3.32]) higher among infected pregnant women compared women.

Language: Английский

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Preterm Birth and SARS-CoV-2: Does a Correlation Exist?

Biomedicines, Journal Year: 2025, Volume and Issue: 13(2), P. 282 - 282

Published: Jan. 24, 2025

Introduction: The emergence of the SARS-CoV-2 virus and its subsequent global pandemic have raised significant concerns regarding impact on pregnancy outcomes. This review aims to summarize emerging data risk preterm delivery in pregnant women infected with SARS-CoV-2. Materials Methods: A systematic search was conducted from March 2020 December 2023 using PubMed Web Science, following PRISMA guidelines. Studies correlating maternal COVID-19 infection birth were included. Results: Thirteen studies analyzed, indicating a higher incidence SARS-CoV-2-positive compared controls. average rate patients 18.5%, median 12.75%, while non-infected showed an 10%, 8.2%. Discussion: suggest association between during increased cesarean section. severity symptoms underlying comorbidities further elevate this risk. Notably, infections third trimester pose highest birth. Conclusion: Preventing is crucial mitigate adverse obstetric Close monitoring tailored interventions for women, particularly those later trimesters comorbidities, are imperative reduce improve maternal-fetal

Language: Английский

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The association of post–embryo transfer SARS-CoV-2 infection with early pregnancy outcomes in in vitro fertilization: a prospective cohort study

American Journal of Obstetrics and Gynecology, Journal Year: 2023, Volume and Issue: 230(4), P. 436.e1 - 436.e12

Published: Dec. 20, 2023

Language: Английский

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Maternal and neonatal outcomes of COVID-19 vaccination during pregnancy, a systematic review and meta-analysis

npj Vaccines, Journal Year: 2023, Volume and Issue: 8(1)

Published: July 15, 2023

Abstract Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is associated with increased pregnancy complications. Despite effective vaccination strategies for the general population, evidence on safety and efficacy of disease 2019 (COVID-19) vaccinations in limited due to a lack well-powered studies. The present study compares maternal, neonatal, immunological outcomes between vaccinated pregnant unvaccinated women using systematic review meta-analysis approach. We included 37 studies total 141,107 (36.8% vaccinated) spread across all outcomes. Our indicates higher rate cesarean section 1898 compared 6180 who did not receive (OR = 1.20, CI (1.05, 1.38), P 0.007, I2 45%). Regarding outcomes, risk SARS-CoV-2 infection during or postpartum was significantly reduced 6820 17,010 0.25, 0.13–0.48, < 0.0001, I 61%), as evident from qualitative assessment indicating antibody titers that observed both mothers have recently recovered infection. analysis represents high quality showing COVID-19 effectively raises against SARS-CoV-2. This may confer protection period. In addition being protective SARS-CoV-2, vaccine decreased odds preterm delivery. Furthermore, also be section.

Language: Английский

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