797 Adverse outcomes among individuals with and without SARS-CoV-2 infection: a systematic review and meta-analysis

Mulder, Isabelle A.; Huntley, Benjamin; Di Mascio, Daniele; Berghella, Vincenzo; Chauhan, Suneet P.

Objective: We sought to compare adverse neonatal and maternal outcomes between individuals who delivered with and without laboratory-confirmed SARS-CoV-2 infection. Study Design: A systematic literature search of MEDLINE, Ovid, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Library was performed on July 17, 2020 (PROSPERO CRD42020203475). Two additional eligible articles published on or before September 12, 2020 were included in the analysis. Two independent reviewers identified publications that directly compared outcomes among pregnant individuals with positive versus negative SARS-CoV-2 tests. We excluded publications with fewer than twenty gravid individuals in either cohort, review articles, or no data on primary outcomes (intrauterine fetal demise [IUFD] and neonatal death). Study effects were reported as odds ratios (OR) with 95% confidence interval (CI). Result(s): Of the 911 abstracts identified, 4 studies met inclusion criteria. Among these studies, 3553 individuals who delivered were tested for SARS-CoV-2 infection, and 14.8% (527) were positive. IUFD and neonatal death occurred at similar rates between the two groups (Table 1). Maternal outcomes including cesarean delivery and maternal death did not significantly differ between groups. However, rates of preterm birth, postpartum fever, maternal respiratory support, and maternal ICU admission were significantly greater in the SARS-CoV-2-positive group (Table 2). Conclusion(s): Current literature supports no observed difference in rates of IUFD, neonatal death, or maternal death between individuals with and without SARS-CoV-2 infection. Our conclusion may warrant revision as additional studies are published. [Formula presented] [Formula presented]Copyright © 2020