COVID-19 during pregnancy should we really worry from vertical transmission or rather from fetal hypoxia and placental insufficiency? A systematic review

• Main Authors: Antoine AbdelMassih (Author), Raghda Fouda (Author), Rana Essam (Author), Alhussein Negm (Author), Dalia Khalil (Author), Dalia Habib (Author), George Afdal (Author), Habiba-Allah Ismail (Author), Hadeer Aly (Author), Ibrahim Genedy (Author), Layla El Qadi (Author), Leena Makki (Author), Maha Shulqamy (Author), Maram Hanafy (Author), Marian AbdelMassih (Author), Marina Ibrahim (Author), Mohamed Ebaid (Author), Monica Ibrahim (Author), Nadine El-Husseiny (Author), Nirvana Ashraf (Author), Noura Shebl (Author), Rahma Menshawey (Author), Rama Darwish (Author), Rana ElShahawi (Author), Rana Ramadan (Author), Sadra Albala (Author), Salwa Imran (Author), Sama Ahmed (Author), Samer Khaldi (Author), Sara Abohashish (Author), Stavro Paulo (Author), Yasmin Omar (Author), Mourad Alfy Tadros (Author)
• Format: Book
• Published: SpringerOpen, 2021-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Abstract Background COVID-19 is the largest outbreak to strike humanity. The wide scale of fatalities and morbidities lead to a concurrent pandemic of uncertainty in scientific evidence. Conflicting evidences are released on daily basis about the neonatal outcomes of COVID-19-positive mothers. The aim of this study was to use the relevant case reports and series to determine the percentage of newborns who test positive for COVID-19 who are born to COVID-19-positive mothers. Secondary outcomes included examining laboratory abnormalities among COVID-19-positive neonates, and any depicted placental abnormalities in COVID-19-positive mothers. For this purpose, systematic review was performed on all studies reporting primary data on fetus-mother pairs with COVID-19. Data bases were searched for studies that met our inclusion and exclusion criteria. Results Final screening revealed 67 studies, from which the primary data of 1787 COVID-19 mothers were identified and had their pregnancy outcome analyzed. Only 2.8% of infants born to COVID-19-positive mothers tested positive, and this finding is identical to percentages reported in former Coronaviridae outbreaks, whereas 20% manifested with intrauterine hypoxia alongside placental abnormalities suggestive of heavy placental vaso-occlusive involvement. Conclusions These findings suggest that while vertical transmission is unlikely, there appears to be an underlying risk of placental insufficiency due to the prothrombotic tendency observed in COVID-19 infection. Guidelines for proper prophylactic anticoagulation in COVID-positive mothers need to be established.

Item Description

10.1186/s43054-021-00056-0
2090-9942