Effects of COVID-19 Infection during Pregnancy and Neonatal Prognosis: What Is the Evidence?
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Abstract
Background: This study’s aims are to assess the current evidence presented in the literature regarding the potential risks of COVID-19 infection among pregnant women and consequent fetal transmission. Methods: a systematic literature review assessing papers published in the most comprehensive databases in the field of health intended to answer the question, “What are the effects of COVID-19 infection during pregnancy, and what is the neonatal prognosis?” Results: 49 papers published in 2020 were eligible, presenting low levels of evidence. A total of 755 pregnant women and 598 infants were assessed; more than half of pregnant women had C-sections (379/65%). Only 493 (82%) infants were tested for SARS-CoV-2, nine (2%) of whom tested positive. There is, however, no evidence of vertical transmission based on what has been assessed so far, considering there are knowledge gaps concerning the care provided during and after delivery, as well as a lack of suitable biological samples for testing SARS-CoV-2. Conclusions: We cannot rule out potential worsening of the clinical conditions of pregnant women infected with SARS-CoV-2, whether the infection is associated with comorbidities or not, due to the occurrence of respiratory disorders, cardiac rhythm disturbances, and acid-base imbalance, among others. We recommend relentless monitoring of all pregnant women in addition to testing them before delivery or the first contact with newborns.
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SciScore for 10.1101/2020.04.17.20069435: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Manuscripts that contained only data from pregnant women, or only fetuses, or that did not address the period of delivery, such as puerperium, were disregarded. Table 2: Resources
Software and Algorithms Sentences Resources The PECO[12] method was adopted, in which: A search was conducted in the following databases: US National Library of Medicine (PubMed), Scopus, Embase, ScienceDirect (Elsevier), Web of Science (WoS), Scholar Google and preprints servers bioRxiv and medRxiv, as well as the bibliographic references of the selected papers (hand … SciScore for 10.1101/2020.04.17.20069435: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Manuscripts that contained only data from pregnant women, or only fetuses, or that did not address the period of delivery, such as puerperium, were disregarded. Table 2: Resources
Software and Algorithms Sentences Resources The PECO[12] method was adopted, in which: A search was conducted in the following databases: US National Library of Medicine (PubMed), Scopus, Embase, ScienceDirect (Elsevier), Web of Science (WoS), Scholar Google and preprints servers bioRxiv and medRxiv, as well as the bibliographic references of the selected papers (hand searching). Embasesuggested: (EMBASE, RRID:SCR_001650)bioRxivsuggested: (bioRxiv, RRID:SCR_003933)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:Despite the limitations, these tests should be used to screen, evaluate, and monitor this kind of infection. [60] Concerning childbirth, 503 were reported, with more than half of pregnant women having cesarean deliveries (324/64%). When checking the indications for cesarean section, in 156 pregnant women, pregnancy-related comorbidities were the cause, 99 were described in the studies as an indication for infection, and 69 did not provide a description of the indication. Regarding the indication for cesarean section because of the infection, the indications were not reported. In most cases, the time of delivery was determined by obstetric indications, rather than the maternal diagnosis of COVID-19.[61] The decision for the type of delivery is usually more influenced by the presence of maternal and/or fetal impairment. When there were imminent risks, emergency cesarean section was the alternative, which has happened in the case of SARS-CoV-2 infections in which the pregnant woman’s clinical condition is complex. However, in the presence of COVID-19, the threshold for cesarean delivery became lower than usual so that infection control procedures could be more easily adhered to and the transmission of the disease to the fetus minimized. [62] Regarding the characteristics of the newborns, 511 babies were born, being 503 single, and 8 twins. The normal Apgar score and normal birth weight were verified in 498 (97%) and 337 (66%) newborns, respectively. A total of 410 (80%), 96 (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.
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