Clinical features, treatments and perinatal outcomes of novel coronavirus infection during pregnancy: a systematic review

Abstract

Objectives: To collect all studies related to COVID-19 infected pregnant women and summarize the symptoms, laboratory findings, treatments, and perinatal outcomes. Methods: The systematic review was conducted according to the PRISMA consensus statement. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane databases on April 3, 2020. All studies relevant to COVID-19 infection among pregnant women are considered for inclusion. A total of 12 studies are considered for inclusion in this systematic review. Two authors extracted the data by using pre-designed, piloted, and customized data extraction form. Results : Fever (60.2%), cough (36.6%), and postpartum fever (23.5%) are the most common symptoms observed in pregnant women infected with COVID 19. The most common abnormal laboratory finding observed in COVID 19 infected pregnant women include; raised AST or ALT (21.0%), lymphopenia (55.8%), elevated C-reactive protein (62.2%), and abnormal chest CT scan (90.2%). Oxygen administration, antibiotic, and antiviral therapy is the mainstay of management strategy in the majority of the studies. Chloroquine and hydroxychloroquine are not advised in pregnancy due to secondary complications. The most common adverse obstetric and neonatal outcomes are preterm delivery, C-section, fetal distress, and low birth weight. There was no vertical transmission of COVID 19 from mother to fetus. Conclusion: Fever, cough, postpartum fever, elevated C-reactive protein, lymphopenia, and abnormal chest CT are the most common clinical and laboratory examinations in pregnant women infected with COVID-19. All healthcare professionals need to consider possible outcomes in this review and make a decision to reduce the risk of complications in both mother and fetus.

Keywords

• covid-19
• novel coronavirus
• neonatal outcomes
• perinatal outcomes
• symptoms
• lab abnormalities