Researchers from various facilities in the United States describe the effects of a sequential, prospective meta-analysis of more than 13,000 pregnant women in a recent BMJ Global Health study. Using a harmonized knowledge collection and analytical strategy, researchers assessed the threat of maternal and fetal death, and neonatal morbidity and mortality in women diagnosed with coronavirus disease 2019 (COVID-19) during pregnancy.
Pregnancy brings with it various physiological, immunomodulatory and mechanical adjustments that increase a woman’s susceptibility to certain diseases, such as COVID-19, and their serious effects.
A meta-analysis of 47 studies suggests that this patient population has a higher threat of mortality, intensive care unit (ICU) admission, preterm birth, stillbirth, and neonatal care unit admission than pregnant women without COVID-19. Another recent report found that women diagnosed with COVID-19 at the time of delivery were also more likely to require prolonged hospitalization involving extensive care for mother and child.
Despite those observations, researchers are unable to synthesize the available data on the effect of COVID-19 during pregnancy due to the widespread heterogeneity of those studies in definitions of final outcomes, population-specific baseline risks, and strategies used to diagnose COVID-19. In addition, pregnant women in low-income countries have not been extensively studied.
The existing examination concerned knowledge gathering from independent studies, harmonised knowledge definitions, and a meta-analytic framework of individual player knowledge (IPD). of COVID-19. In particular, a diagnosis of COVID-19 has been demonstrated by polymerase chain reaction (PCR) tests, antigen tests, serological tests after a known exposure or according to the World Health Organization (WHO) definition of a suspected case.
To ensure the integrity of the RPI for the study, the researchers identified any potential outliers and inconsistent values for knowledge issues such as gestational age at birth, maternal age, and newborn birth weight. The four categories of patients’ final outcomes assessed in the study included maternal mortality and morbidity, fetal and neonatal mortality and morbidity, adverse final outcomes of delivery, and severe COVID-19 end outcomes.
Overall, a total of 12 studies conducted between February 2020 and July 2021 were included in the final analysis. These studies were conducted in 12 countries, in addition to Ghana, China-Hong Kong, Italy, Kenya, Nigeria, South Africa, Spain, Sweden, the Democratic Republic of Congo, Turkey, Uganda and the United States. As a result, a total of 1,942 pregnant women with COVID-19 and 11,194 negative pregnant women for COVID-19 were included.
Compared to pregnant women who tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a diagnosis of COVID-19 at any time during pregnancy increases a woman’s threat of all critical signs of COVID-19. These severe effects of COVID-19 included admission to intensive care, any use of ventilation, and pneumonia diagnosed by a physician.
Specifically, COVID-19 increased the absolute threat of a pregnant woman being admitted to the ICU and desires for intensive care by 3% and 4%, respectively. Pregnant women diagnosed with COVID-19 were five times more likely to require extensive care than pregnant women with SARS. Negative conditions for CoV-2.
In particular, such adverse events were less common in pregnant women with symptomatic COVID-19. In addition, the risk of maternal death was also particularly higher in pregnant women with symptomatic infection than in uninfected women.
Of the 3 included studies that reported deaths during the study period, COVID-19 increased the risk of maternal death. An increased risk of preeclampsia, thromboembolic disease, and hypertensive disorders of pregnancy was also observed in pregnant women with COVID-19.
The threat of cesarean section was higher in pregnant women diagnosed with COVID-19. In particular, no significant differences were identified in the threat of preterm labour, haemorrhage, placental abruption, eclampsia or intrapartum caesarean delivery.
An increased threat of admission to the neonatal ICU (NICU) has been reported in infants born to mothers diagnosed with COVID-19. These findings are consistent with other studies, such as the INTERCOVID study, which reported an increased threat of preterm birth in women. inflamed with SARS-CoV-2.
In addition, babies born to inflamed mothers were more likely to be born preterm and premature, as well as to have low birth weight.
While a diagnosis of COVID-19 particularly increased the risk of many markers of maternal morbidity and mortality, as well as neonatal outcomes, symptomatic infections were an even more important risk for those adverse events.
Taken together, these findings highlight the importance of continued surveillance in pregnant women to prevent SARS-CoV-2 infection through vaccination and the use of non-pharmaceutical interventions such as masks and social distancing.
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