Perinatal outcomes and vertical transmission by SARS-CoV2 infection
(COVID-19) during pregnancy: systematic review and meta-analysis.
Abstract
Background: COVID-19 is a new pandemic disease with severe respiratory
outcome. However, there is little evidence of this condition during
pregnancy based on small case series reports. Objective: to perform a
systematic review and meta-analysis of proportions of case series
focused on maternal and perinatal outcomes of COVID-19 during pregnancy.
Search strategy: LILACS and Medline were searched from inception until
April 24th, 2020. Selection criteria: all case series or case control
studies involving SARS-CoV2 infection during pregnancy and neonatal
period were identified. Excluded were duplicated data, case reports of
individual patients or without clinical data. Data collection and
analysis: a total of 14 studies were included. When possible, pooled
proportions with 95% confidence interval through a random effect model
were estimated. Heterogeneity was estimated with the use of I2
statistics and Tau2 test. Main results: Most common symptoms were fever
(58%; I2= 69%) and cough (33%; I2= 65%). A pathognomonic CT-Scan was
observed in 92% of patients (I2= 0%). Lymphopenia and increased
D-dimer were observed in 50% (I2= 82%), and 80% (I2= 0%) of patients
at admission, respectively. There were no maternal deaths, with 2 cases
of neonatal death, both with negative SARS-CoV2 PCR. Vertical
transmission was observed in 5 neonates. Conclusions: This systematic
review and meta-analysis confirms that COVID-19 during pregnancy is
associated with good maternal and perinatal outcome. Evidence of
vertical transmission should be confirmed with larger cohorts. Funding:
none. Key words: meta-analysis, COVID-19, vertical transmission,
perinatal outcome, pregnancy.