Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis
<b>Background:</b> Coronavirus disease (COVID-19) is a pandemic causing respiratory symptoms, taste alterations, olfactory disturbances, and cutaneous, cardiovascular, and neurological manifestations. Recently, research interest has shifted to reproductive health to understand the factor...
| Main Authors: | , , , , |
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| Format: | Article |
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MDPI AG
2023-08-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/9/1337 |
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| author | Rossella Cannarella Raneen Sawaid Kaiyal Marta Marino Sandro La Vignera Aldo E. Calogero |
| author_facet | Rossella Cannarella Raneen Sawaid Kaiyal Marta Marino Sandro La Vignera Aldo E. Calogero |
| author_sort | Rossella Cannarella |
| collection | DOAJ |
| description | <b>Background:</b> Coronavirus disease (COVID-19) is a pandemic causing respiratory symptoms, taste alterations, olfactory disturbances, and cutaneous, cardiovascular, and neurological manifestations. Recently, research interest has shifted to reproductive health to understand the factors predisposing to COVID-19 infection in pregnancy, the consequences of the infection on the fetus and on the mother, and possible vertical transmission through the placenta. Pregnancy does not increase the risk of SARS-CoV-2 infection, according to studies. However, contrary to non-pregnant women, pregnancy worsens the clinical outcome of COVID-19. Studies investigating the effects of COVID-19 on pregnancy women are heterogeneous, and the results are often conflicting. <b>Objectives:</b> The goal of the current work was to offer a thorough and up-to-date systematic review of, and meta-analysis on, the impact of COVID-19 on ovarian function, pregnancy, and fetal outcomes. <b>Search strategy:</b> This meta-analysis (PROSPERO n. CRD42023456904) was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. The search for relevant material was conducted using PubMed, Scopus, Cochrane, and Embase databases, through to 15 December 2022. <b>Selection criteria:</b> Original articles on fertile pregnant women or women attempting to become pregnant, with an active case of, or history of, SARS-CoV-2 infection were included, and reproductive function was compared to that of uninfected women. <b>Data collection and analysis:</b> The effects of COVID-19 on female reproductive function, particularly ovarian function, the profile of female sex hormones, pregnancy outcomes and fetal outcomes were the focus of our search. Quantitative analysis was performed with Comprehensive Meta-Analysis Software. The standard difference of the mean was calculated for the statistical comparison between cases and controls. Cochran’s Q test and heterogeneity (I<sup>2</sup>) indexes were used to assess statistical heterogeneity. Sensitivity analysis and publication bias tests were also performed. <b>Main Results:</b> Twenty-eight articles met our inclusion criteria, for a total of 27,383 patients pregnant or looking to have offspring, with active or anamnestic COVID-19, and 1,583,772 uninfected control women. Our study revealed that there was no significant difference between COVID-19 patients and the control group in terms of maternal characteristics such as age, body mass index (BMI) and comorbidities that could affect pregnancy and fetal outcomes. The risk of a miscarriage or Cesarean delivery was significantly lower, while the risk of fetal death or premature delivery was significantly higher in COVID-19 patients than in the controls. None of the included studies evaluated hormonal profiles or investigated the presence of infertility. <b>Conclusions:</b> Maternal comorbidities, age, and BMI do not raise the risk of COVID-19. However, pregnant women with COVID-19 had a lower risk of miscarriage and Cesarean delivery, possibly because of better prenatal care and high levels of observation during labor. COVID-19 during pregnancy increases the risk of fetal death and premature delivery. |
| first_indexed | 2024-03-10T22:33:45Z |
| format | Article |
| id | doaj.art-20b2c746344448a59727a4d79e22cb58 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T22:33:45Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-20b2c746344448a59727a4d79e22cb582023-11-19T11:30:49ZengMDPI AGJournal of Personalized Medicine2075-44262023-08-01139133710.3390/jpm13091337Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-AnalysisRossella Cannarella0Raneen Sawaid Kaiyal1Marta Marino2Sandro La Vignera3Aldo E. Calogero4Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyGlickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USADepartment of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, Italy<b>Background:</b> Coronavirus disease (COVID-19) is a pandemic causing respiratory symptoms, taste alterations, olfactory disturbances, and cutaneous, cardiovascular, and neurological manifestations. Recently, research interest has shifted to reproductive health to understand the factors predisposing to COVID-19 infection in pregnancy, the consequences of the infection on the fetus and on the mother, and possible vertical transmission through the placenta. Pregnancy does not increase the risk of SARS-CoV-2 infection, according to studies. However, contrary to non-pregnant women, pregnancy worsens the clinical outcome of COVID-19. Studies investigating the effects of COVID-19 on pregnancy women are heterogeneous, and the results are often conflicting. <b>Objectives:</b> The goal of the current work was to offer a thorough and up-to-date systematic review of, and meta-analysis on, the impact of COVID-19 on ovarian function, pregnancy, and fetal outcomes. <b>Search strategy:</b> This meta-analysis (PROSPERO n. CRD42023456904) was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. The search for relevant material was conducted using PubMed, Scopus, Cochrane, and Embase databases, through to 15 December 2022. <b>Selection criteria:</b> Original articles on fertile pregnant women or women attempting to become pregnant, with an active case of, or history of, SARS-CoV-2 infection were included, and reproductive function was compared to that of uninfected women. <b>Data collection and analysis:</b> The effects of COVID-19 on female reproductive function, particularly ovarian function, the profile of female sex hormones, pregnancy outcomes and fetal outcomes were the focus of our search. Quantitative analysis was performed with Comprehensive Meta-Analysis Software. The standard difference of the mean was calculated for the statistical comparison between cases and controls. Cochran’s Q test and heterogeneity (I<sup>2</sup>) indexes were used to assess statistical heterogeneity. Sensitivity analysis and publication bias tests were also performed. <b>Main Results:</b> Twenty-eight articles met our inclusion criteria, for a total of 27,383 patients pregnant or looking to have offspring, with active or anamnestic COVID-19, and 1,583,772 uninfected control women. Our study revealed that there was no significant difference between COVID-19 patients and the control group in terms of maternal characteristics such as age, body mass index (BMI) and comorbidities that could affect pregnancy and fetal outcomes. The risk of a miscarriage or Cesarean delivery was significantly lower, while the risk of fetal death or premature delivery was significantly higher in COVID-19 patients than in the controls. None of the included studies evaluated hormonal profiles or investigated the presence of infertility. <b>Conclusions:</b> Maternal comorbidities, age, and BMI do not raise the risk of COVID-19. However, pregnant women with COVID-19 had a lower risk of miscarriage and Cesarean delivery, possibly because of better prenatal care and high levels of observation during labor. COVID-19 during pregnancy increases the risk of fetal death and premature delivery.https://www.mdpi.com/2075-4426/13/9/1337COVID-19pregnancymiscarriagebirthweightdeliverySGA |
| spellingShingle | Rossella Cannarella Raneen Sawaid Kaiyal Marta Marino Sandro La Vignera Aldo E. Calogero Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis Journal of Personalized Medicine COVID-19 pregnancy miscarriage birthweight delivery SGA |
| title | Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis |
| title_full | Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis |
| title_fullStr | Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis |
| title_short | Impact of COVID-19 on Fetal Outcomes in Pregnant Women: A Systematic Review and Meta-Analysis |
| title_sort | impact of covid 19 on fetal outcomes in pregnant women a systematic review and meta analysis |
| topic | COVID-19 pregnancy miscarriage birthweight delivery SGA |
| url | https://www.mdpi.com/2075-4426/13/9/1337 |
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