Clinical characteristics of COVID-19 infection in pregnant women: a systematic review and meta-analysis

  1. Sina Arabi
  2. Golnaz Vaseghi
  3. Zahra Heidari
  4. Laleh Shariati
  5. Bahareh Amin
  6. Harunor Rashid
  7. Shaghayegh Haghjooy Javanmard

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Abstract

Background

On December 2019, Novel coronavirus disease (COVID-19) was detected in Wuhan, China, and then spread around the world. There is little information about effects of COVID-19 on Pregnant women and newborns as a sensitive population. The current study is a systemic review and Meta-analysis to measure the risks and determine the presentations of COVID-19 in pregnant women and newborn.

Methods

online data bases were searched on march 20. Heterogeneity of the included studies was assessed using the Cochran Q test and Higgins I 2 statistic and expressed as percentage. All data were analyzed with 95% confidence intervals.

Results

A total of 7 studies involving 50 participants with Positive test of COVID-19 were enrolled. Mean age of pregnant women was 30.57 years old and the Mean Gestational age was 36.9 weeks. Other variables such as Apgar score, birth weight, Sign and symptoms, Complications and Laboratory data were Analyzed.

Conclusion

Our findings showed same clinical characteristics in pregnant women as in non-pregnant adults, with the main symptoms being cough and fever. No vertical transmission was seen and all patients delivered healthy neonates. Our findings would be of great help to the decision making process, regarding the management of pregnant women diagnosed with COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.05.20053983: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy and selection criteria: A systematic search was carried out in databases (PubMed, Embase and Cochrane Library) to identify published studies included epidemiological studies and case-control studies.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane Library
    suggested: (Cochrane Library, RRID:SCR_013000)
    Statistical analysis: The meta-analysis was performed using “metan” and “metaprop” programs in STATA version 11 (STATA, College Station, TX, USA) based on clinical characteristics of COVID-19 infection as input.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    In addition to the limiting number of studies included in this meta-analysis, another caveat is that all included studies were from China. The results of four studies showed that 61% of the affected family members also had the disease. Because of close contact with the patient’s aerosols, the patient’s family members are at greater risk. This meta-analysis showed that all pregnant women underwent C-section. It is not clear that the vertical transmission risk of 2019-nCov in C-section is lower than vaginal delivery (15). It seems that physicians think C-section is the better option for delivery. The surgery should be done in a negative-pressure operating room, and doctors should follow some protective measures like using a N95 mask, wearing a medical protective suit and goggles to avoid contamination with droplets from the surgical site (16). Our analysis showed that all pregnant women delivered live and healthy infants that were negative tested for 2019-nCov. This result indicates that the possibility of vertical transmission is very low, and performing intra-operative hygiene procedures and transferring the baby to an isolated ward will help to protect the baby from getting infected with COVID-19.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.04.05.20053983v1 on medRxiv