Possibility of Vertical Transmission of COVID-19 During Pregnancy, Labor and After Delivery: A Systematic Review Study

Ameneh Rahnama, Ali Salimi Asl, Z. Kazemi, M. Nobakht, Mahshid Abbaszadeh, F. Dabiri, N. Roozbeh
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Abstract

Background: In general, although the placenta is a good barrier to prevent infections, several cases of coronavirus disease 19 (COVID-19) transmission have been reported during pregnancy. Moreover, considering the potential for vertical maternal-fetal transmission, there is a concern that the fetus is at risk for congenital COVID-19. The aim of the present review and systematic study was to investigate the possibility of the vertical transmission of COVID-19 during pregnancy, labor, and postpartum using available data. Methods: Studies conducted by February 12, 2021 were included in this systematic review study. Articles were searched in Medline, Magiran, SID, Civilica, Irandoc, ScienceDirect, PubMed, EMBASE, Web of Science, Scopus, and Google Scholar using English keywords such as "Coronavirus", "COVID-19, "SARS-CoV-2", "Vertical intrauterine transmission", "Vertical transmission", "Vertical fetal infection", "Maternal infection", and "Fetal infection". The inclusion criterion included all observational studies related to vertical maternal-fetal transmission. Overall, 31 articles were completely analyzed after reviewing and deleting non-eligible and duplicate articles. Results: The results of reviewing 24 studies showed that collected samples were all negative but positive blood samples, immunoglobulin M (IgM) and IgG antibodies, and expression of placental factors were reported in seven studies. Conclusion: Although contradictory results were found in this study, the results of the samples revealed the lowest probability of vertical transmission. There was also no evidence confirming the effectiveness of cesarean section in reducing the rate of transmission. In general, adherence to hygienic protocols can have a significant impact on reducing neonatal incidence.
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COVID-19在妊娠、分娩和分娩后垂直传播的可能性:一项系统综述研究
背景:一般来说,虽然胎盘是预防感染的良好屏障,但已有几例冠状病毒病19 (COVID-19)在怀孕期间传播的报道。此外,考虑到母婴垂直传播的可能性,人们担心胎儿有先天性COVID-19的风险。本综述和系统研究的目的是利用现有数据调查COVID-19在妊娠、分娩和产后垂直传播的可能性。方法:本系统综述研究纳入了2021年2月12日之前进行的研究。使用“冠状病毒”、“COVID-19”、“SARS-CoV-2”、“垂直宫内传播”、“垂直传播”、“垂直胎儿感染”、“母体感染”和“胎儿感染”等英文关键词在Medline、Magiran、SID、Civilica、Irandoc、ScienceDirect、PubMed、EMBASE、Web of Science、Scopus和谷歌Scholar中检索文章。纳入标准包括所有与母胎垂直传播相关的观察性研究。在审查和删除不合格和重复的文章后,总共分析了31篇文章。结果:回顾24项研究的结果显示,采集的血样均为阴性但阳性,7项研究报告了免疫球蛋白M (IgM)和IgG抗体以及胎盘因子的表达。结论:虽然本研究中发现了相互矛盾的结果,但样本结果显示垂直传播的可能性最低。也没有证据证实剖宫产术在降低传播率方面的有效性。一般来说,遵守卫生规程可对降低新生儿发病率产生重大影响。
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