Maternal death related to COVID‐19: A systematic review and meta‐analysis focused on maternal co‐morbidities and clinical characteristics

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  • Marco La Verde
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Gaetano Riemma
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Marco Torella
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Stefano Cianci
    Dipartimento di Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva Policlinico G. Martino Università degli studi di Messina Messina Italy
  • Fabiana Savoia
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Federico Licciardi
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Serena Scida
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Maddalena Morlando
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Nicola Colacurci
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy
  • Pasquale De Franciscis
    Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit University of Campania “Luigi Vanvitelli” Naples Italy

説明

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Besides reducing the quality of obstetric care, the direct impact of COVID‐19 on pregnancy and postpartum is uncertain.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the characteristics of pregnant women who died due to COVID‐19.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>Cochrane Library, Embase, MEDLINE, Scopus, and Google Scholar were searched from inception to February 2021.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies that compared deceased and survived pregnant women with COVID‐19.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Relevant data were extracted and tabulated. The primary outcome was maternal co‐morbidity.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>Thirteen studies with 154 deceased patients were included. Obesity doubled the risk of death (relative risk [RR] 2.48, 95% confidence interval [CI] 1.41–4.36, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%). No differences were found for gestational diabetes (RR 5.71; 95% CI 0.77–42.44, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 94%) or asthma (RR 2.05, 95% CI 0.81–5.15, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%). Overall, at least one severe co‐morbidity showed a twofold increased risk of death (RR 2.26, 95% CI 1.77–2.89, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 76%). Admission to intensive care was related to a fivefold increased risk of death (RR 5.09, 95% CI 2.00–12.98, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 56%), with no difference in need for respiratory support (RR 0.53, 95% CI 0.23–1.48, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 95%) or mechanical ventilation (RR 4.34, 95% CI 0.96–19.60, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 58%).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>COVID‐19 with at least one co‐morbidity increases risk of intensive care and mortality.</jats:p></jats:sec>

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