COVID-19 and pregnancy: epidemiology, clinical features, maternal and perinatal outcomes. A systematic review

Abstract

Background and objectives: COVID-19 pandemic had quite a significant impact on a number of obstetric outcomes. This is often directly attributed to complications of COVID-19. This article is a systematically review literature on the epidemiology, clinical features, maternal and perinatal outcomes of COVID-19 in pregnancy.Materials and methods. A PRISMA methodology search was conducted on the databases of PubMed, Scopus, Medline, Google Scholar, Web of Science and Central BMJ using MeSH keywords or combinations of the words “COVID-19”, “SARS-CoV-2”, “pregnancy”, “epidemiology”, “comorbid disease”, “pregnancy and childbirth outcome”, “preeclampsia”, “fetus”. Only articles published between December 1, 2019 to February 28, 2022 were considered. After preliminary analysis of more than 600 publications, 21 articles were short-listed for final processing. The studies were selected using a Newcastle-Ottawa scale style questionnaire. The clinical features, risk factors, co-morbid conditions, maternal and neonatal outcomes were presented in two separate tables respectively. Results. COVID-19 incidence in pregnancy ranged from 4.9% to 10.0%. Such women were 5.4 times more likely to be hospitalized and 1.5 times more to need ICU care. Dyspnoea and hyperthermia were associated with a high risk of severe maternal (OR 2.56; 95% CI 1.92–3.40) and neonatal complications (OR 4.97; 95% CI 2.11–11.69). One in ten of neonates had a small weight for gestational age (9.27 ± 3.18%) and one in three required intensive care unit observation.Conclusions. Despite the increasingly emerging evidence on the associations between pregnancy and COVID-19 infection, the data is sometimes contradictory necessitating further studies.