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

Durray Shahwar A. Khan, Areeba N. Pirzada, Anna Ali, Rehana A. Salam, Jai K. Das and Zohra S. Lassi
Additional contact information
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

IJERPH, 2021, vol. 18, issue 11, 1-23

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.

Keywords: COVID-19; SARS-CoV-2; coronavirus 2; pregnant; non-pregnant adults; child-bearing age women (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/11/5613/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/11/5613/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:11:p:5613-:d:561287

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().