Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis
Amidst the COVID-19 pandemic, there is a need for further research on its manifestation in pregnant women, since they are particularly prone to respiratory pathogens, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to physiological changes during pregnancy. Its effects on infa...
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| Format: | Article |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Global Women's Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2021.647072/full |
| _version_ | 1818326526925471744 |
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| author | Clark Zhang Haitao Chu Y. Veronica Pei Jason Zhang |
| author_facet | Clark Zhang Haitao Chu Y. Veronica Pei Jason Zhang |
| author_sort | Clark Zhang |
| collection | DOAJ |
| description | Amidst the COVID-19 pandemic, there is a need for further research on its manifestation in pregnant women, since they are particularly prone to respiratory pathogens, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to physiological changes during pregnancy. Its effects on infants born to mothers with COVID-19 are also not well-studied, and more evidence is needed on vertical transmission of the disease from mother to infant and on the transmission of IgG/IgM antibodies between mother and infant. We aim to systematically review and evaluate the effects of COVID-19 among SARS-CoV-2-positive pregnant women in late pregnancy and neonates with SARS-CoV-2-positive pregnant mothers using blood assays to find indicators of maternal and neonatal complications. We searched for original published articles in Google Scholar, Medline (PubMed), and Embase databases to identify articles in the English language from December 2019 to July 20, 2020. Duplicate entries were searched by their titles, authors, date of publication, and Digital Object Identifier. The selected studies were included based on patient pregnancy on admission, pregnant mothers with laboratory-confirmed COVID-19 virus, maternal/neonatal complications, and blood test results. We excluded duplicate studies, articles where full text was not available, other languages than English, opinions, and perspectives. The meta-analysis using the Generalized Linear Mixed model was conducted using the “meta” and “metaprop” packages in R code. Of the 1,642 studies assessed for eligibility, 29 studies (375 mothers and neonates) were included. Preterm birth rate was 34.2%, and cesarean section rate was 82.7%. Maternal laboratory findings found elevated neutrophils (71.4%; 95% CI: 38.5–90.9), elevated CRP (67.7%; 95%: 50.6–81.1), and low hemoglobin (57.3%; 95% CI: 26.0–87.8). We found platelet count, lactate dehydrogenase, and procalcitonin to be less strongly correlated with preterm birth than between high neutrophil counts (P = 0.0007), low hemoglobin (P = 0.0188), and risk of preterm birth. There is little evidence for vertical transmission. Elevated procalcitonin levels (23.2%; 95% CI: 8.4–49.8) are observed in infants born to mothers with COVID-19, which could indicate risk for neonatal sepsis. These infants may gain passive immunity to COVID-19 through antibody transfer via placenta. These results can guide current obstetrical care during the current SARS-CoV-2 pandemic. |
| first_indexed | 2024-12-13T12:01:47Z |
| format | Article |
| id | doaj.art-a52aae73d0bc48cba8559c7870fb5cc5 |
| institution | Directory Open Access Journal |
| issn | 2673-5059 |
| language | English |
| last_indexed | 2024-12-13T12:01:47Z |
| publishDate | 2021-04-01 |
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| series | Frontiers in Global Women's Health |
| spelling | doaj.art-a52aae73d0bc48cba8559c7870fb5cc52022-12-21T23:47:05ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592021-04-01210.3389/fgwh.2021.647072647072Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-AnalysisClark Zhang0Haitao Chu1Y. Veronica Pei2Jason Zhang3Division of Biostatistics, University of Minnesota, Minneapolis, MN, United StatesDivision of Biostatistics, University of Minnesota, Minneapolis, MN, United StatesDepartment of Emergency Medicine, University of Maryland, Baltimore, MD, United StatesDivision of Biostatistics, University of Minnesota, Minneapolis, MN, United StatesAmidst the COVID-19 pandemic, there is a need for further research on its manifestation in pregnant women, since they are particularly prone to respiratory pathogens, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to physiological changes during pregnancy. Its effects on infants born to mothers with COVID-19 are also not well-studied, and more evidence is needed on vertical transmission of the disease from mother to infant and on the transmission of IgG/IgM antibodies between mother and infant. We aim to systematically review and evaluate the effects of COVID-19 among SARS-CoV-2-positive pregnant women in late pregnancy and neonates with SARS-CoV-2-positive pregnant mothers using blood assays to find indicators of maternal and neonatal complications. We searched for original published articles in Google Scholar, Medline (PubMed), and Embase databases to identify articles in the English language from December 2019 to July 20, 2020. Duplicate entries were searched by their titles, authors, date of publication, and Digital Object Identifier. The selected studies were included based on patient pregnancy on admission, pregnant mothers with laboratory-confirmed COVID-19 virus, maternal/neonatal complications, and blood test results. We excluded duplicate studies, articles where full text was not available, other languages than English, opinions, and perspectives. The meta-analysis using the Generalized Linear Mixed model was conducted using the “meta” and “metaprop” packages in R code. Of the 1,642 studies assessed for eligibility, 29 studies (375 mothers and neonates) were included. Preterm birth rate was 34.2%, and cesarean section rate was 82.7%. Maternal laboratory findings found elevated neutrophils (71.4%; 95% CI: 38.5–90.9), elevated CRP (67.7%; 95%: 50.6–81.1), and low hemoglobin (57.3%; 95% CI: 26.0–87.8). We found platelet count, lactate dehydrogenase, and procalcitonin to be less strongly correlated with preterm birth than between high neutrophil counts (P = 0.0007), low hemoglobin (P = 0.0188), and risk of preterm birth. There is little evidence for vertical transmission. Elevated procalcitonin levels (23.2%; 95% CI: 8.4–49.8) are observed in infants born to mothers with COVID-19, which could indicate risk for neonatal sepsis. These infants may gain passive immunity to COVID-19 through antibody transfer via placenta. These results can guide current obstetrical care during the current SARS-CoV-2 pandemic.https://www.frontiersin.org/articles/10.3389/fgwh.2021.647072/fullCOVID-19preterm birthneonatal sepsismeta-analysisblood assayvertical transmission |
| spellingShingle | Clark Zhang Haitao Chu Y. Veronica Pei Jason Zhang Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis Frontiers in Global Women's Health COVID-19 preterm birth neonatal sepsis meta-analysis blood assay vertical transmission |
| title | Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis |
| title_full | Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis |
| title_fullStr | Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis |
| title_short | Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis |
| title_sort | laboratory effects of covid 19 infection in pregnant women and their newborns a systematic review and meta analysis |
| topic | COVID-19 preterm birth neonatal sepsis meta-analysis blood assay vertical transmission |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2021.647072/full |
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