Clinical Presentation and Outcomes of Pregnant Women With Coronavirus Disease 2019: A Systematic Review and Meta-analysis

Clin Infect Dis. 2021 Feb 1;72(3):521-533. doi: 10.1093/cid/ciaa828.


Background: Descriptions of coronavirus disease 2019 (COVID-19) have focused on the nonpregnant adult population. This study aims to describe the clinical characteristics and perinatal outcomes of COVID-19 in pregnancy.

Methods: We searched databases from December 2019 to 30 April 2020. Eligible studies reported clinical characteristics, radiological findings, and/or laboratory testing of pregnant women during infection. Data were pooled across studies using a random-effects model.

Results: Twenty-four studies (136 women) were included. The most common symptoms were fever (62.9%) and cough (36.8%). Laboratory findings included elevated C-reactive protein (57%) and lymphocytopenia (50%). Ground-glass opacity was the most common radiological finding (81.7%). Preterm birth rate was 37.7% and cesarean delivery rate was 76%. There was 1 maternal death. There were 2 fetal COVID-19 cases.

Conclusions: The clinical picture in pregnant women with COVID-19 did not differ from the nonpregnant population; however, the rate of preterm birth and cesarean delivery are considerably higher than international averages.

Keywords: coronavirus; neonates; pregnant; transmission.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • COVID-19*
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Outcome
  • Pregnant Women
  • Premature Birth* / epidemiology
  • SARS-CoV-2