Excess of cesarean births in pregnant women with COVID‐19: A meta‐analysis

Background Studies have suggested that cesarean birth in pregnant women with COVID‐19 may decrease maternal adverse events and perinatal transmission. This systematic review aimed to evaluate variations in clinical presentation, laboratory findings, and maternal/neonatal outcomes in COVID‐19 patients who delivered vaginally versus via cesarean. Methods A comprehensive search following PRISMA guidelines was performed for studies published up to May 23, 2020, using PubMed, Web of Science, Scopus, Embase, Cochrane, Science Direct, and clinicaltrials.gov. Original retrospective and prospective studies, case reports, or case series with sufficient data for estimating the association of COVID‐19 with different pregnancy outcomes with no language restriction and published in peer‐reviewed journals were included. Pooled mean and arcsine transformation proportions were applied. Next, a two‐arm meta‐analysis was performed comparing the perinatal outcomes between the study groups. Results Forty‐two studies with a total of 602 pregnant women with COVID‐19 were included. The mean age was 31.8 years. Subgroup analysis showed that Americans had the lowest gestational age (mean = 32.7, 95%CI = 27.0‐38.4, P