A Systematic Review and Meta-analysis of Pregnancy and COVID-19: Signs and Symptoms, Laboratory Tests and Perinatal Outcomes

Background COVID-19 caused by severe acute respiratory syndrome coronavirus 2 appeared in December 2019 in Wuhan, China. Objective We aimed to investigate the clinical manifestation include signs and symptoms, laboratory results, and perinatal outcomes in pregnant women with COVID-19. Materials and Methods We searched PubMed via LitCovid hub, Embase, Scopus, Web of sciences, and Google scholar on 07 April 2020. Meta-analysis was performed via CMA software using the Mantel-Haenszel method. The event rate with 95% CI was calculated for each variable. Results Ten studies were selected. The pooled prevalence for fever, post-partum fever, cough, myalgia, fatigue, dyspnea, sore throat, and diarrhea were 66.8 %, 37.1 %, 35.5 %, 24.6 %, 14.9%, 14.6 %, 11.5%, and 7.6 %, respectively. Laboratory test results were 49.8 % for lymphopenia, 47.7 % for leukocytosis, 83.7 % for elevated neutrophil ratio, 57 % for elevated C-reactive protein, and 71.4 % for decreased lymphocyte ratio. The rate of cesarean section for delivery in all cases was 84%. Only one case was the newborn of a mother with COVID-19 positive. Also, there was only one death due to Decreased lymphocyte ratio. Conclusion Fever was the most common signs and symptoms in pregnant women with COVID-19. Among the laboratory tests, the highest amount was related to elevated neutrophil ratio. It seems that due to the differences between pregnant women and the general population, special measures should be considered to treat these patients.