Article ; Online: Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis.
2021 Volume 9, Issue 6, Page(s) e759–e772
Abstract: ... We did a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal ... Global maternal and fetal outcomes have worsened during the COVID-19 pandemic, with an increase ... the collective evidence on the effects on maternal, fetal, and neonatal outcomes of the pandemic.: Methods ...
| Abstract | Background: The COVID-19 pandemic has had a profound impact on health-care systems and potentially on pregnancy outcomes, but no systematic synthesis of evidence of this effect has been undertaken. We aimed to assess the collective evidence on the effects on maternal, fetal, and neonatal outcomes of the pandemic. Methods: We did a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal, and neonatal outcomes. We searched MEDLINE and Embase in accordance with PRISMA guidelines, from Jan 1, 2020, to Jan 8, 2021, for case-control studies, cohort studies, and brief reports comparing maternal and perinatal mortality, maternal morbidity, pregnancy complications, and intrapartum and neonatal outcomes before and during the pandemic. We also planned to record any additional maternal and offspring outcomes identified. Studies of solely SARS-CoV-2-infected pregnant individuals, as well as case reports, studies without comparison groups, narrative or systematic literature reviews, preprints, and studies reporting on overlapping populations were excluded. Quantitative meta-analysis was done for an outcome when more than one study presented relevant data. Random-effects estimate of the pooled odds ratio (OR) of each outcome were generated with use of the Mantel-Haenszel method. This review was registered with PROSPERO (CRD42020211753). Findings: The search identified 3592 citations, of which 40 studies were included. We identified significant increases in stillbirth (pooled OR 1·28 [95% CI 1·07-1·54]; I Interpretation: Global maternal and fetal outcomes have worsened during the COVID-19 pandemic, with an increase in maternal deaths, stillbirth, ruptured ectopic pregnancies, and maternal depression. Some outcomes show considerable disparity between high-resource and low-resource settings. There is an urgent need to prioritise safe, accessible, and equitable maternity care within the strategic response to this pandemic and in future health crises. Funding: None. |
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| MeSH term(s) | COVID-19 ; Female ; Global Health ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome |
| Language | English |
| Publishing date | 2021-03-31 |
| Publishing country | England |
| Document type | Journal Article ; Meta-Analysis ; Systematic Review |
| ZDB-ID | 2723488-5 |
| ISSN | 2214-109X ; 2214-109X |
| ISSN (online) | 2214-109X |
| ISSN | 2214-109X |
| DOI | 10.1016/S2214-109X(21)00079-6 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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