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Given their potential for immunocompromise, pregnant women with SARS-CoV-2 infection could be at excess risk for poor outcomes. Investigators conducted a systematic review and meta-analysis of studies published from the initial identification of SARS-CoV-2 through April 23, 2020. The 13 eligible articles each reported outcomes in ≥10 pregnant women with confirmed infection (435 deliveries; 342 in China, 51 in the U.S., and 42 in Italy).
Incidence of maternal intensive care unit admission was 3.0%, frequency of critical disease diagnosis (defined as respiratory failure, septic shock, and multiorgan dysfunction or failure) was 1.4%, and no deaths were reported. The preterm birth (PTB) rate was 20.1% among SARS-CoV-2 patients (compared with 10%–11% worldwide) and the cesarean delivery rate was 84.7% (nearly 3 times the baseline rate in the 3 included countries). Vertical transmission occurred in none of the deliveries and neonatal death in 0.3%.
Huntley BJF et al. Rates of maternal and perinatal mortality and vertical transmission in pregnancies complicated by severe acute respiratory syndrome coronavirus 2 (SARS-Co-V-2) infection: A systematic review. Obstet Gynecol 2020 Jun 9; 136:303. (https://doi.org/10.1097/AOG.0000000000004010)
Comment
These initial findings are encouraging. However — particularly as information continues to amass globally during the pandemic — obstetric clinicians must be mindful that SARS-CoV-2 infection is associated with increased likelihood of PTB and cesarean delivery and should counsel their patients accordingly.