A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity.
A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity.
复制标题
DOI：
10.7189/jogh.11.05018
复制
发表时间：
2021-06-30
影响因子：
7.2
通讯作者：
Bhutta ZA
中科院分区：
文献类型：
--
作者：
Lassi ZS;Ana A;Das JK;Salam RA;Padhani ZA;Irfan O;Bhutta ZA
我们确定了确诊COVID-19的孕妇的临床表现、风险因素以及妊娠和围产期结局，并根据COVID-19的严重程度确定了这些是否不同。我们纳入了所有关于确诊COVID-19的孕妇的观察性研究，报告了临床表现、风险因素以及妊娠和围产期结局。我们纳入了Medline、Embase、WHO COVID-19数据库和clinicaltrials. gov中2019年12月至2021年2月期间发表的所有研究。使用NHLBI标准评估队列和病例系列的方法学质量。纳入了来自62项研究的31016名孕妇。女性平均年龄为30.9岁，大多数（77.7%）处于妊娠晚期，16.4%的女性患上了严重的COVID-19。近一半是无症状的，而最常见的症状是咳嗽，发烧，疲劳和嗅觉丧失/味觉丧失。约7%的患者被送入重症监护室（ICU），8%的患者需要机械通气，2%的患者死亡。近80%的妇女分娩; 48.4%的妇女剖腹产。在新生儿中，23.4%为早产（<37周），16.6%为低出生体重，23.7%入住新生儿ICU。共记录了21例死产（1.6%）和24例新生儿死亡（1.6%），50名婴儿（3.5%）呈COVID-19阳性。对患有严重和非严重COVID-19的孕妇进行比较的研究显示，患有严重COVID-19的女性年龄大3.7岁，而在35岁以上的女性中，患严重COVID-19的风险高出1.5倍。肥胖、吸烟、糖尿病和先兆子痫的女性患严重COVID-19的风险明显更高。在患有严重COVID-19的妇女中，早产的风险几乎是2.4倍。我们的审查表明，在具有某些人口统计和健康特征的妇女中，COVID-19严重程度和不良妊娠及围产期结局的风险较高。这些发现可以为当前指南的形成提供信息;然而，随着全球COVID-19疫情的发展，这些指南应该不断更新。PROSPERO：CRD 42020182048。
We determined the clinical presentation, risk factors, and pregnancy and perinatal outcomes in pregnant women with confirmed COVID-19 and identified if these are different based on COVID-19 severity. We included all observational studies on pregnant women with confirmed COVID-19 reporting clinical presentation, risk factors, and pregnancy and perinatal outcomes. We included all studies published between Dec/2019-Feb/2021 in Medline, Embase, the WHO COVID-19 databases, and clinicaltrials.gov. The methodological quality of cohort and case-series was assessed using NHLBI criteria. 31 016 pregnant women from 62 studies were included. Women were an average of 30.9 years of age, most (77.7%) were in the third trimester, and 16.4% developed severe COVID-19. Nearly half were asymptomatic, while the most commonly reported symptoms were cough, fever, fatigue, and anosmia/ageusia. About 7% were admitted to the intensive care unit (ICU), 8% required mechanical ventilation, and 2% of the women died. Almost 80% of women delivered; 48.4% had cesarean births. Among newborns, 23.4% were preterm (<37 weeks), 16.6% were low birth weight, and 23.7% were admitted to neonatal ICU. A total of 21 stillbirths (1.6%) and 24 neonatal deaths (1.6%) were recorded, while 50 babies (3.5%) were COVID-19 positive. Studies comparing pregnant women with severe and non-severe COVID-19 showed that women with severe COVID-19 were 3.7 years older and the risk of severe COVID-19 was 1.5 times higher among women >35 years. The risk of severe COVID-19 was significantly higher among women who were obese, had smoked, diabetic, and had pre-eclampsia. The risk of preterm birth was almost 2.4 folds among women with severe COVID-19. Our review suggests a heightened risk of COVID-19 severity and adverse pregnancy and perinatal outcomes among women with certain demographic and health profiles. These findings can inform the formation of current guidelines; however, these should be constantly updated as the global COVID-19 scenario unfolds. PROSPERO: CRD42020182048.
登录
查看更多内容
DOI：
10.1111/1471-0528.16278
发表时间：
2020-05-28
影响因子：
5.8
作者：
Ferrazzi, E.;Frigerio, L.;Cetin, I
通讯作者：
Cetin, I
影响因子：
7.2
作者：
Goldfarb, Ilona Telefus;Clapp, Mark A.;Bryant, Allison S.
通讯作者：
Bryant, Allison S.
影响因子：
9.8
作者：
Lokken, Erica M.;Walker, Christie L.;Waldorf, Kristina M. Adams
通讯作者：
Waldorf, Kristina M. Adams
DOI：
10.1016/j.jogoh.2020.101826
发表时间：
2020-09-01
影响因子：
1.9
作者：
Kayem, Gilles;Lecarpentier, Edouard;Schmitz, Thomas
通讯作者：
Schmitz, Thomas
DOI：
10.1136/archdischild-2020-319990
发表时间：
2021-01-01
影响因子：
4.4
作者：
Hedermann, Gitte;Hedley, Paula Louise;Lausten-Thomsen, Ulrik
通讯作者：
Lausten-Thomsen, Ulrik