Clinical features and outcomes of pregnant women with COVID-19: a
systematic review and meta-analysis
Abstract
Background: COVID-19 outbreak in Wuhan, China recently. It quickly
spread throughout. Objectives: To investigate clinical features and
outcomes of pregnant women with COVID-19. Search Strategy: PubMed、Web
of Science、EMBASE、MEDLINE were searched from January 1, 2020 to April
16, 2020. Selection Criteria: Case review of pregnant women infected
with COVID-19 Data Collection and Analysis: Two reviewers screened 366
literatures and 14 studies included, four reviewers independently
extracted the features of the literatures. We used random-effects model
to analyze incidence (P) and 95% confidence interval (95%CI).
Heterogeneity was assessed using the I2 statistic. Main Results: The
meta- analysis included 236 pregnant women with COVID-19. The results
were as follows: positive CT findings (71%; 95%CI,
0.49~0.93), cesarean section (65%; 95%CI,
0.42~0.87), fever (51%; 95%CI,
0.35~0.67), lymphopenia (49%; 95%CI,
0.29~0.70), coexisting disorders (33%; 95%CI,
0.21~0.44), cough (31%; 95%CI,
0.23~0.39), fetal distress (29%; 95%CI,
0.08~0.49), preterm labor (23%; 95%CI,
0.14~0.32), severe case or death (12%; 95%CI,
0.03~0.20). The subgroup analysis showed compared with
nonpregnant patients, pregnant women with COVID-19 had significantly
lower incidences of fever (pregnant women group, 51%; nonpregnant
patients group, 91%; P<0.00001) and cough (pregnant women group, 31%;
nonpregnant patients group, 67%; P<0.0001). Conclusions: The incidence
of fever, cough and positive CT findings in pregnant women with COVID-19
is less than that in the general population, preterm labor is the
opposite. There is no evidence that COVID-19 can propagate vertically
for the time being. Keywords: 2019-nCoV, COVID-19, clinical features,
pregnancy outcomes, pregnant women, meta-analysis