COVID-19 in pregnant women and neonates: Clinical characteristics and laboratory and imaging findings. An overview of systematic reviews

Abstract

Introduction: SARS-CoV-2 infection in the perinatal period may be associated with an increased risk of morbidity and mortality in both the mother and the neonate. Objective: To describe the clinical characteristics and laboratory and imaging findings in pregnant women with COVID-19 and their newborns. Materials and methods: A search was conducted in PubMed, Scopus, Web of Science, and Cochrane databases for systematic reviews published between February 1, 2020, and May 30, 2021, describing clinical characteristics and laboratory and imaging (chest) findings in pregnant women with COVID-19 and their newborns; there were no language restrictions. Data were reanalyzed by means of Bayesian meta-analysis using Markov Chain Monte Carlo (MCMC) methods. The study protocol is registered in PROSPERO under code CRD42020178329. Results: Six systematic reviews were retrieved (for a total of 617 primary studies). A narrative synthesis of the percentage of signs, symptoms, and imaging and laboratory findings found in both mothers and neonates was performed. Odds ratios (OR) between pregnant women with and without COVID-19 were: fetal well-being involvement: 1.9 (95%CI: 1.09-3.63); stillbirth: 1.73 (95%CI: 1.01-2.94); preterm birth: 1.77 (95%CI: 1.25-2.61); and maternal admission to the intensive care unit (ICU): 6.75 (95%CI: 1-31.19). Regarding symptomatology, an OR of 0.67 (95%CI: 0.51-0.93) was obtained for myalgia between pregnant women and non-pregnant women with COVID-19. Conclusions: Cough, fever, dyspnea, and myalgia are the most common symptoms in pregnant women with COVID-19; in addition, there is a higher risk of admission to the ICU among them. Regarding complementary testing, the most frequent alterations are lymphopenia and the evidence of lesions in chest imaging studies. The presence of COVID-19 in pregnant women is associated with preterm birth. It seems that SARS-CoV-2 infection in neonates is not severe and that the risk of vertical transmission is low, considering that no data on congenital malformations attributable to the virus were found.