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The Differences in Clinical Presentation, Management, and Prognosis of Laboratory-Confirmed COVID-19 between Pregnant and Non-Pregnant Women: A Systematic Review and Meta-Analysis

Author

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  • Durray Shahwar A. Khan

    (Department of Maternal and Child Health, Aga Khan University, Karachi 74800, Pakistan)

  • Areeba N. Pirzada

    (Department of Maternal and Child Health, Aga Khan University, Karachi 74800, Pakistan)

  • Anna Ali

    (Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia)

  • Rehana A. Salam

    (Department of Maternal and Child Health, Aga Khan University, Karachi 74800, Pakistan)

  • Jai K. Das

    (Department of Maternal and Child Health, Aga Khan University, Karachi 74800, Pakistan)

  • Zohra S. Lassi

    (Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia)

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people across the globe. Previous coronavirus outbreaks led to worsened symptoms amongst pregnant women, suggesting that pregnant women are at greater risk. Objectives: Our aim is to investigate the differences in clinical presentation, management, and prognosis of COVID-19 infection in pregnant and non-pregnant women. Methods: We ran a search on electronic databases and analysis of the relevant articles was done using Revie Manager 5.4. Results: The review consists of nine studies comprising 591,058 women (28,797 pregnant and 562,261 non-pregnant), with most of the data derived from two large studies. The risk of experiencing fever (RR: 0.74; 95% CI: 0.64–0.85), headache (RR: 0.77; 95% CI: 0.74–0.79), myalgia (RR: 0.92; 95% CI: 0.89–0.95), diarrhea (RR: 0.40, 95% CI: 0.39–0.43), chest tightness (RR: 0.86; 95% CI: 0.77–0.95), and expectoration (RR: 0.45; 95% CI: 0.21–0.97) were greater amongst non-pregnant COVID-19-infected women. Pregnant women with COVID-19 were less likely to be obese (RR: 0.68; 95% CI: 0.63–0.73) or have a smoking history (RR: 0.32; 95% CI: 0.26–0.39). COVID-19-infected non-pregnant women had a higher frequency of comorbidity such as chronic cardiac disease (RR: 0.58; 95% CI: 0.44–0.77), renal disease (RR: 0.45; 95% CI: 0.29–0.71), and malignancy (RR: 0.82; 95% CI: 0.68–0.98), compared to COVID-19-infected pregnant women. The risk of ICU admission (RR: 2.26; 95% CI: 1.68–3.05) and requirement of invasive mechanical ventilation (RR: 2.68; 95% CI: 2.07–3.47) were significantly higher amongst pregnant women. Conclusions: Although the frequency of risk factors and the risk of experiencing clinical symptoms of COVID-19 were higher among non-pregnant women, COVID-19-infected pregnant women had a higher requirement of ICU admission and invasive mechanical ventilation compared to non-pregnant COVID-19-infected women. More well-conducted studies from varying contexts are needed to draw conclusions. Prospero registration: CRD42020204638.

Suggested Citation

  • Durray Shahwar A. Khan & Areeba N. Pirzada & Anna Ali & Rehana A. Salam & Jai K. Das & Zohra S. Lassi, 2021. "The Differences in Clinical Presentation, Management, and Prognosis of Laboratory-Confirmed COVID-19 between Pregnant and Non-Pregnant Women: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(11), pages 1-23, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5613-:d:561287
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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