Mortality and morbidity among pregnant women with COVID-19 infection: a meta-analysis

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared as a global pandemic in March 2020. There is a special immune tolerance in pregnant woman, predisposes to a viral infection, then increased risk severe complication. Meta analysis was performed using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidlines with comprehensive literature study was performed in July 2021 through Science Direct, Cochrane, and PubMed, with keywords “COVID-19”, “SARS-CoV-2”, “pregnancy”, “pregnant”, and “complication”, and each parameter we assessed using review manager 5.3. Nine studies with 30,257 infected patients and 1,678,974 non infected patients were included. The data show that preterm birth (odds ratio (OR)=1.43, 95% confidence interval (CI): 1.17-1.74; p=0.0004, inconsistency (I2) =90%) less in non infected groups, no camparable finding in vaginal delivery (OR=0.93, 95% CI: 0.82-1.06; p<0.030, I2=75%) and caesarian delivery (OR=1.07, 95% CI: 0.90-1.28; p<0.045, I2=96%). Intensive care unit (ICU) admission reported high percentage in infected patients (OR=4.87, 95% CI: 3.08-7.71; p<0.0001, I2=93%), we found that obstetric complication in subgroup (OR=1.31, 95% CI: 0.13-1.52; p<0.0003, I2=54%) and mortality (OR=17.41, 95% CI: 11.04-27.46; p<0.0001, I2=0%) less in non infected patients. Pregnancy with infected COVID-19 has high percentage of mortality and morbidity events. Infected and non infected patient has equal chance for vaginal or caesarian delivery.