VP45.28: Effects of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcomes: a systematic review

To perform a systematic review of available published literature on pregnancies affected by COVID-19 to evaluate the effects of COVID-19 on maternal, perinatal and neonatal outcomes. We performed a systematic review to evaluate the effects of COVID-19 on pregnancy, perinatal and neonatal outcomes. We conducted a comprehensive literature search using PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure Database and Wan Fang Data until 20 April 2020 (studies were identified through PubMed alert after 20 April 2020). Eligibility criteria included COVID-19 diagnosis, patient was pregnant on admission, availability of clinical characteristics, including maternal, perinatal or neonatal outcomes. 19 studies, including 266 pregnant women with COVID-19, were included. Among the seven case-series, the maternal age ranged from 20 to 41 years and the gestational age (GA) on admission ranged from 5 to 41 weeks. The most common symptoms were fever, cough, dyspnea and fatigue. The rate of severe pneumonia was relatively low, with the majority of the cases requiring ICU admission. Almost all cases from the case-series had positive CT chest findings. There were 6 and 22 cases that had nucleic-acid testing in vaginal mucus and breast milk, respectively, which were negative for SARS-CoV2. 177 cases had delivered, of which the majority by Caesarean section. The GA at delivery ranged from 28 to 41 weeks. Over one-third of neonates were transferred to NICU. There was one case each of neonatal asphyxia and death. There were 113 neonates that had nucleic-acid testing in throat swab, which was negative for SARS-CoV2. From the case reports, there were two maternal deaths reported. The clinical characteristics of pregnant women with COVID-19 are similar to those of nonpregnant adults with COVID-19. The subject of vertical transmission of SARS-CoV2 remains controversial and more data is needed to investigate this possibility.