مقاله انگلیسی رایگان در مورد نتیجه عفونتهای طیف کروناویروس – الزویر 2020

The aim of this systematic review was to report pregnancy and perinatal outcomes of coronavirus spectrum infections, and particularly coronavirus 2019 (COVID-19) disease because of severe acute respiratory syndromeecoronavirus-2 infection during pregnancy. DATA SOURCES: Medline, Embase, Cinahl, and Clinicaltrials.gov databases were searched electronically utilizing combinations of word variants for coronavirus or severe acute respiratory syndrome or SARS or Middle East respiratory syndrome or MERS or COVID-19 and pregnancy. The search and selection criteria were restricted to English language. STUDY ELIGIBILITY CRITERIA: Inclusion criteria were hospitalized pregnant women with a confirmed coronavirus relatedeillness, defined as severe acute respiratory syndrome, Middle East respiratory syndrome, or COVID-19. STUDY APPRAISAL AND SYNTHESIS METHODS: We used meta-analyses of proportions to combine data and reported pooled proportions. The pregnancy outcomes observed included miscarriage, preterm birth, preeclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and mode of delivery. The perinatal outcomes observed were fetal distress, Apgar score <7 at 5 minutes, neonatal asphyxia, admission to a neonatal intensive care unit, perinatal death, and evidence of vertical transmission. RESULTS: Nineteen studies including 79 hospitalized women were eligible for this systematic review: 41 pregnancies (51.9%) affected by COVID-19, 12 (15.2%) by Middle East respiratory syndrome, and 26 (32.9%) by severe acute respiratory syndrome. An overt diagnosis of pneumonia was made in 91.8%, and the most common symptoms were fever (82.6%), cough (57.1%), and dyspnea (27.0%). For all coronavirus infections, the rate of miscarriage was 39.1% (95% confidence interval, 20.2e59.8); the rate of preterm birth <37 weeks was 24.3% (95% confidence interval, 12.5e38.6); premature prelabor rupture of membranes occurred in 20.7% (95% confidence interval, 9.5e34.9), preeclampsia in 16.2% (95% confidence interval, 4.2e34.1), and fetal growth restriction in 11.7% (95% confidence interval, 3.2e24.4); 84% were delivered by cesarean; the rate of perinatal death was 11.1% (95% confidence interval, 84.8e19.6), and 57.2% of newborns (95% confidence interval, 3.6e99.8) were admitted to the neonatal intensive care unit. When focusing on COVID-19, the most common adverse pregnancy outcome was preterm birth <37 weeks, occurring in 41.1% of cases (95% confidence interval, 25.6e57.6), while the rate of perinatal death was 7.0% (95% confidence interval, 1.4e16.3). None of the 41 newborns assessed showed clinical signs of vertical transmission. CONCLUSION: In hospitalized mothers infected with coronavirus infections, including COVID-19, >90% of whom also had pneumonia, preterm birth is the most common adverse pregnancy outcome. COVID-19 infection was associated with a relatively higher rate of preterm birth, preeclampsia, cesarean, and perinatal death.