Epidemiologic characteristics, clinical management, and public health implications of Coronavirus Disease 2019 (COVID-19) in pregnancy: A Systematic Review and Meta-analysis

Nepal J Epidemiol. 2021 Dec 31;11(4):1103-1125. doi: 10.3126/nje.v11i4.41911. eCollection 2021 Dec.


Background: The novel Coronavirus Disease 2019 (COVID-19) outbreak, caused by the pathogenic severe acute respiratory syndrome-2 (SARS-CoV-2) virus, is exponentially spreading across the globe.

Methods: The current systematic review was performed utilising the following electronic databases PubMed, MEDLINE and EMBASE. We searched for the keywords "COVID-19 AND "pregnancy" between January 1, 2020 until December 31, 2020.

Results: Out of 4005 records which were identified, 36 original studies were included in this systematic review. Pooled prevalence of vertical transmission was 10%, 95% CI: 4-17%. Pooled prevalence of neonatal mortality was 7%, 95% CI: 0-21%.

Conclusion: The contemporary evidence suggests that the incubation period of COVID-19 is 2-14 days, and this infection could be transmitted even from the infected asymptomatic individuals. It is found that the clinical presentation of pregnant women with COVID-19 infection is comparable with the infected non-pregnant females, and the frequent symptoms were fever, cough, myalgia, sore throat and malaise. Some cases have severe maternal morbidity and perinatal deaths secondary to COVID-19 infection. Under these circumstances, pregnant women should focus on maintaining personal hygiene, proper nutrition and extreme social distancing to reduce the risk of COVID-19. Therefore, systematic data reporting for evidence based clinical assessment, management and pregnancy outcomes is essential for preventing of COVID-19 infection among pregnant women.

Keywords: Childbirth; Clinical Management; Complications; Pandemic; Pregnancy; Prevention.