Outcome of SARS-CoV-2 in pregnancy and newborns – is there a new kid in the TORCH block?

Abstract

Objective. This study aimed to perform a systematic review of existing literature to assess the outcomes of pregnancy in women with COVID-19 infection and their newborns while estimating the possibility of vertical transmission. Materials and methods. We conducted a systematic literature research using Pubmed and Google Scholar covering the period from December 2019 to 20th of November 2020. The review was conducted in accordance with PRISMA guidelines. Outcomes. We included 16 studies – systematic reviews and meta-analyses published between May 2020 and November 2020 – which focused on perinatal outcomes of pregnant women with COVID-19 and 7 case reports of neonates with congenital transmission of COVID-19. Overall, the rate of COVID-19 cases in neonates of COVID-19 positive mothers was 3% with 95% CI [1.86, 4.24]). The preterm birth rate was 16.4% with 95% CI [10.5, 22.3] and the rate of stillbirths and foetal deaths was 1.4% (11 studies, 0 to 4.8%). From the 7 newborns with proved vertical transmission, majority were born preterm, with good birth weight and APGAR score and heterogenous symptoms; 4 developed severe symptoms. Overall progress and evolution for both mother and newborn was good. Conclusions. COVID-19 impact on pregnancy outcome is similar to general population in regard to preterm rate and stillbirth rate. Vertical transmission is possible and it seems to occur in about 3% of cases. Overall maternal and perinatal outcome is favourable and clinical presentation of in utero transmission of SARSCoV-2 in newborns is heterogenous.