Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis (1 September 2020)

Summary

Allotey et al. determined the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed COVID-19.

The authors found that pregnant and recently pregnant women are less likely to manifest COVID-19 related symptoms of fever and myalgia than non-pregnant women of reproductive age and are potentially more likely to need intensive care treatment for COVID-19. Pre-existing comorbidities, high maternal age, and high body mass index seem to be risk factors for severe COVID-19. Preterm birth rates are high in pregnant women with covid-19 than in pregnant women without the disease.

Content

What this means for healthcare professionals

• Based on existing data, healthcare professionals should be aware that pregnant and recently pregnant women with COVID-19 might manifest fewer symptoms than the general population, with the overall pattern similar to that of the general population.
• Emerging comparative data indicate the potential for an increase in the rates of admission to intensive care units and invasive ventilation in pregnant women compared with non-pregnant women.
• Mothers with pre-existing comorbidities will need to be considered as a high risk group for COVID-19, along with those who are obese and of greater maternal age.
• Clinicians will need to balance the need for regular multidisciplinary antenatal care to manage women with pre-existing comorbidities against unnecessary exposure to the virus, through virtual clinic appointments when possible.
• Pregnant women with COVID-19 before term gestation might need to be managed in a unit with facilities to care for preterm neonates.