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 patient...
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| Veröffentlicht in: | Birth (Berkeley, Calif.) Calif.), 2022-06, Vol.49 (2), p.179-193 |
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| creator | Omar, Mahmoud Youssef, Mohanad R. Trinh, Lily N. Attia, Abdallah S. Elshazli, Rami M Jardak, Christina L Farhoud, Ashraf S Hussein, Mohammad H Shihabi, Areej Elnahla, Ahmed Zora, Ghassan Abdelgawad, Mohamed Munshi, Ruhul Aboueisha, Mohamed Toraih, Eman A. Fawzy, Manal S Kandil, Emad |
| description | 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 |
| doi_str_mv | 10.1111/birt.12609 |
| format | Article |
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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 < 0.001) and the highest incidence of maternal ICU admission (95%CI = 0.45%‐2.20, P < 0.001) of all nationalities in the study. There was no significant difference in perinatal complications, premature rupture of membrane, placenta previa/accreta, or gestational hypertension/pre‐eclampsia between women who delivered vaginally versus by cesarean. Importantly, there were also no significant differences in maternal or neonatal outcomes.
Conclusion
Vaginal delivery was not associated with worse maternal or neonatal outcomes when compared with cesarean. The decision to pursue a cesarean birth should be based on standard indications, not COVID‐19 status.</description><identifier>ISSN: 0730-7659</identifier><identifier>EISSN: 1523-536X</identifier><identifier>DOI: 10.1111/birt.12609</identifier><identifier>PMID: 34997608</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Births ; Cesarean section ; cesarean/vaginal delivery ; Childbirth & labor ; COVID-19 ; Critical incidents ; Disease control ; Eclampsia ; Female ; Gestational age ; Humans ; Hypertension ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Intensive care ; maternal/neonatal outcome ; Meta-analysis ; Newborn babies ; Perinatal ; Placenta ; Pregnancy ; Pregnancy Outcome - epidemiology ; Pregnant Women ; Premature Birth - epidemiology ; Prospective Studies ; Retrospective Studies ; SARS-CoV-2 ; Systematic review ; Transformation ; Womens health</subject><ispartof>Birth (Berkeley, Calif.), 2022-06, Vol.49 (2), p.179-193</ispartof><rights>2022 Wiley Periodicals LLC</rights><rights>2022 Wiley Periodicals LLC.</rights><rights>Copyright © 2022 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3579-9c50312360dfc56564225e1ab496584273eab1e1d1169ec9fbaf6293d83788423</citedby><cites>FETCH-LOGICAL-c3579-9c50312360dfc56564225e1ab496584273eab1e1d1169ec9fbaf6293d83788423</cites><orcidid>0000-0002-8616-6081 ; 0000-0001-9267-3787 ; 0000-0001-8278-7094 ; 0000-0003-1252-8403 ; 0000-0003-3937-8425 ; 0000-0003-2163-0637 ; 0000-0002-6973-5561 ; 0000-0002-4586-1918 ; 0000-0002-3381-2641 ; 0000-0001-5895-4403 ; 0000-0001-8534-6630</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbirt.12609$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbirt.12609$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,30976,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34997608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Omar, Mahmoud</creatorcontrib><creatorcontrib>Youssef, Mohanad R.</creatorcontrib><creatorcontrib>Trinh, Lily N.</creatorcontrib><creatorcontrib>Attia, Abdallah S.</creatorcontrib><creatorcontrib>Elshazli, Rami M</creatorcontrib><creatorcontrib>Jardak, Christina L</creatorcontrib><creatorcontrib>Farhoud, Ashraf S</creatorcontrib><creatorcontrib>Hussein, Mohammad H</creatorcontrib><creatorcontrib>Shihabi, Areej</creatorcontrib><creatorcontrib>Elnahla, Ahmed</creatorcontrib><creatorcontrib>Zora, Ghassan</creatorcontrib><creatorcontrib>Abdelgawad, Mohamed</creatorcontrib><creatorcontrib>Munshi, Ruhul</creatorcontrib><creatorcontrib>Aboueisha, Mohamed</creatorcontrib><creatorcontrib>Toraih, Eman A.</creatorcontrib><creatorcontrib>Fawzy, Manal S</creatorcontrib><creatorcontrib>Kandil, Emad</creatorcontrib><title>Excess of cesarean births in pregnant women with COVID‐19: A meta‐analysis</title><title>Birth (Berkeley, Calif.)</title><addtitle>Birth</addtitle><description>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 < 0.001) and the highest incidence of maternal ICU admission (95%CI = 0.45%‐2.20, P < 0.001) of all nationalities in the study. There was no significant difference in perinatal complications, premature rupture of membrane, placenta previa/accreta, or gestational hypertension/pre‐eclampsia between women who delivered vaginally versus by cesarean. Importantly, there were also no significant differences in maternal or neonatal outcomes.
Conclusion
Vaginal delivery was not associated with worse maternal or neonatal outcomes when compared with cesarean. The decision to pursue a cesarean birth should be based on standard indications, not COVID‐19 status.</description><subject>Adult</subject><subject>Births</subject><subject>Cesarean section</subject><subject>cesarean/vaginal delivery</subject><subject>Childbirth & labor</subject><subject>COVID-19</subject><subject>Critical incidents</subject><subject>Disease control</subject><subject>Eclampsia</subject><subject>Female</subject><subject>Gestational age</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infant, Newborn</subject><subject>Infectious Disease Transmission, Vertical</subject><subject>Intensive care</subject><subject>maternal/neonatal outcome</subject><subject>Meta-analysis</subject><subject>Newborn babies</subject><subject>Perinatal</subject><subject>Placenta</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Pregnant Women</subject><subject>Premature Birth - epidemiology</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Systematic review</subject><subject>Transformation</subject><subject>Womens health</subject><issn>0730-7659</issn><issn>1523-536X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9kMtKw0AUhgdRbK1ufAAZcCNC6lwyk4y7WqsWigWp4m6YpBObkkudSajd-Qg-o0_ixFQXLjybn8P5-Dj8ABxj1MduLqLUVH1MOBI7oIsZoR6j_HkXdFFAkRdwJjrgwNolQijwfb4POtQXIuAo7IL70VusrYVlAl0qo1UBG9_CwrSAK6NfClVUcF3muoDrtFrA4fRpfP35_oHFJRzAXFfKLapQ2cam9hDsJSqz-mibPfB4M5oN77zJ9HY8HEy8mLJAeCJmiGJCOZonMeOM-4QwjVXkC85CnwRUqwhrPMeYCx2LJFIJJ4LOQxqE7k574Kz1rkz5WmtbyTy1sc4yVeiytpJwHDpliLBDT_-gy7I27t-G4oQ5Y9AIz1sqNqW1RidyZdJcmY3ESDYty6YV-d2yg0-2yjrK9fwX_anVAbgF1mmmN_-o5NX4YdZKvwCrloZK</recordid><startdate>202206</startdate><enddate>202206</enddate><creator>Omar, Mahmoud</creator><creator>Youssef, Mohanad R.</creator><creator>Trinh, Lily N.</creator><creator>Attia, Abdallah S.</creator><creator>Elshazli, Rami M</creator><creator>Jardak, Christina L</creator><creator>Farhoud, Ashraf S</creator><creator>Hussein, Mohammad H</creator><creator>Shihabi, Areej</creator><creator>Elnahla, Ahmed</creator><creator>Zora, Ghassan</creator><creator>Abdelgawad, Mohamed</creator><creator>Munshi, Ruhul</creator><creator>Aboueisha, Mohamed</creator><creator>Toraih, Eman A.</creator><creator>Fawzy, Manal S</creator><creator>Kandil, Emad</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8616-6081</orcidid><orcidid>https://orcid.org/0000-0001-9267-3787</orcidid><orcidid>https://orcid.org/0000-0001-8278-7094</orcidid><orcidid>https://orcid.org/0000-0003-1252-8403</orcidid><orcidid>https://orcid.org/0000-0003-3937-8425</orcidid><orcidid>https://orcid.org/0000-0003-2163-0637</orcidid><orcidid>https://orcid.org/0000-0002-6973-5561</orcidid><orcidid>https://orcid.org/0000-0002-4586-1918</orcidid><orcidid>https://orcid.org/0000-0002-3381-2641</orcidid><orcidid>https://orcid.org/0000-0001-5895-4403</orcidid><orcidid>https://orcid.org/0000-0001-8534-6630</orcidid></search><sort><creationdate>202206</creationdate><title>Excess of cesarean births in pregnant women with COVID‐19: A meta‐analysis</title><author>Omar, Mahmoud ; Youssef, Mohanad R. ; Trinh, Lily N. ; Attia, Abdallah S. ; Elshazli, Rami M ; Jardak, Christina L ; Farhoud, Ashraf S ; Hussein, Mohammad H ; Shihabi, Areej ; Elnahla, Ahmed ; Zora, Ghassan ; Abdelgawad, Mohamed ; Munshi, Ruhul ; Aboueisha, Mohamed ; Toraih, Eman A. ; Fawzy, Manal S ; Kandil, Emad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3579-9c50312360dfc56564225e1ab496584273eab1e1d1169ec9fbaf6293d83788423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Births</topic><topic>Cesarean section</topic><topic>cesarean/vaginal delivery</topic><topic>Childbirth & labor</topic><topic>COVID-19</topic><topic>Critical incidents</topic><topic>Disease control</topic><topic>Eclampsia</topic><topic>Female</topic><topic>Gestational age</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Infant, Newborn</topic><topic>Infectious Disease Transmission, Vertical</topic><topic>Intensive care</topic><topic>maternal/neonatal outcome</topic><topic>Meta-analysis</topic><topic>Newborn babies</topic><topic>Perinatal</topic><topic>Placenta</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Pregnant Women</topic><topic>Premature Birth - epidemiology</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Systematic review</topic><topic>Transformation</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Omar, Mahmoud</creatorcontrib><creatorcontrib>Youssef, Mohanad R.</creatorcontrib><creatorcontrib>Trinh, Lily N.</creatorcontrib><creatorcontrib>Attia, Abdallah S.</creatorcontrib><creatorcontrib>Elshazli, Rami M</creatorcontrib><creatorcontrib>Jardak, Christina L</creatorcontrib><creatorcontrib>Farhoud, Ashraf S</creatorcontrib><creatorcontrib>Hussein, Mohammad H</creatorcontrib><creatorcontrib>Shihabi, Areej</creatorcontrib><creatorcontrib>Elnahla, Ahmed</creatorcontrib><creatorcontrib>Zora, Ghassan</creatorcontrib><creatorcontrib>Abdelgawad, Mohamed</creatorcontrib><creatorcontrib>Munshi, Ruhul</creatorcontrib><creatorcontrib>Aboueisha, Mohamed</creatorcontrib><creatorcontrib>Toraih, Eman A.</creatorcontrib><creatorcontrib>Fawzy, Manal S</creatorcontrib><creatorcontrib>Kandil, Emad</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Birth (Berkeley, Calif.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Omar, Mahmoud</au><au>Youssef, Mohanad R.</au><au>Trinh, Lily N.</au><au>Attia, Abdallah S.</au><au>Elshazli, Rami M</au><au>Jardak, Christina L</au><au>Farhoud, Ashraf S</au><au>Hussein, Mohammad H</au><au>Shihabi, Areej</au><au>Elnahla, Ahmed</au><au>Zora, Ghassan</au><au>Abdelgawad, Mohamed</au><au>Munshi, Ruhul</au><au>Aboueisha, Mohamed</au><au>Toraih, Eman A.</au><au>Fawzy, Manal S</au><au>Kandil, Emad</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excess of cesarean births in pregnant women with COVID‐19: A meta‐analysis</atitle><jtitle>Birth (Berkeley, Calif.)</jtitle><addtitle>Birth</addtitle><date>2022-06</date><risdate>2022</risdate><volume>49</volume><issue>2</issue><spage>179</spage><epage>193</epage><pages>179-193</pages><issn>0730-7659</issn><eissn>1523-536X</eissn><abstract>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 < 0.001) and the highest incidence of maternal ICU admission (95%CI = 0.45%‐2.20, P < 0.001) of all nationalities in the study. There was no significant difference in perinatal complications, premature rupture of membrane, placenta previa/accreta, or gestational hypertension/pre‐eclampsia between women who delivered vaginally versus by cesarean. Importantly, there were also no significant differences in maternal or neonatal outcomes.
Conclusion
Vaginal delivery was not associated with worse maternal or neonatal outcomes when compared with cesarean. The decision to pursue a cesarean birth should be based on standard indications, not COVID‐19 status.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34997608</pmid><doi>10.1111/birt.12609</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-8616-6081</orcidid><orcidid>https://orcid.org/0000-0001-9267-3787</orcidid><orcidid>https://orcid.org/0000-0001-8278-7094</orcidid><orcidid>https://orcid.org/0000-0003-1252-8403</orcidid><orcidid>https://orcid.org/0000-0003-3937-8425</orcidid><orcidid>https://orcid.org/0000-0003-2163-0637</orcidid><orcidid>https://orcid.org/0000-0002-6973-5561</orcidid><orcidid>https://orcid.org/0000-0002-4586-1918</orcidid><orcidid>https://orcid.org/0000-0002-3381-2641</orcidid><orcidid>https://orcid.org/0000-0001-5895-4403</orcidid><orcidid>https://orcid.org/0000-0001-8534-6630</orcidid></addata></record> |
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| ispartof | Birth (Berkeley, Calif.), 2022-06, Vol.49 (2), p.179-193 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Births Cesarean section cesarean/vaginal delivery Childbirth & labor COVID-19 Critical incidents Disease control Eclampsia Female Gestational age Humans Hypertension Infant, Newborn Infectious Disease Transmission, Vertical Intensive care maternal/neonatal outcome Meta-analysis Newborn babies Perinatal Placenta Pregnancy Pregnancy Outcome - epidemiology Pregnant Women Premature Birth - epidemiology Prospective Studies Retrospective Studies SARS-CoV-2 Systematic review Transformation Womens health |
| title | Excess of cesarean births in pregnant women with COVID‐19: A meta‐analysis |
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