Excess of cesarean births in pregnant women with COVID-19: A meta-analysis.

Autor: Omar M; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Youssef MR; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Trinh LN; School of Medicine, Tulane University, New Orleans, Louisiana, USA., Attia AS; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Elshazli RM; Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy, Horus University - Egypt, New Damietta, Egypt., Jardak CL; School of Medicine, Tulane University, New Orleans, Louisiana, USA., Farhoud AS; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisina, USA., Hussein MH; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Shihabi A; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Elnahla A; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Zora G; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Abdelgawad M; School of Medicine, Tulane University, New Orleans, Louisiana, USA., Munshi R; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Aboueisha M; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisina, USA.; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt., Toraih EA; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA.; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt., Fawzy MS; Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.; Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia., Kandil E; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA.
Jazyk: angličtina
Zdroj: Birth (Berkeley, Calif.) [Birth] 2022 Jun; Vol. 49 (2), pp. 179-193. Date of Electronic Publication: 2022 Jan 07.
DOI: 10.1111/birt.12609
Abstrakt: Background: Studies have suggested that cesarean birth in pregnant women with COVID-19 may decrease maternal adverse events and perinatal transmission. This systematic review aimed to evaluate variations in clinical presentation, laboratory findings, and maternal/neonatal outcomes in COVID-19 patients who delivered vaginally versus via cesarean.
Methods: A comprehensive search following PRISMA guidelines was performed for studies published up to May 23, 2020, using PubMed, Web of Science, Scopus, Embase, Cochrane, Science Direct, and clinicaltrials.gov. Original retrospective and prospective studies, case reports, or case series with sufficient data for estimating the association of COVID-19 with different pregnancy outcomes with no language restriction and published in peer-reviewed journals were included. Pooled mean and arcsine transformation proportions were applied. Next, a two-arm meta-analysis was performed comparing the perinatal outcomes between the study groups.
Results: Forty-two studies with a total of 602 pregnant women with COVID-19 were included. The mean age was 31.8 years. Subgroup analysis showed that Americans had the lowest gestational age (mean = 32.7, 95%CI = 27.0-38.4, P < 0.001) and the highest incidence of maternal ICU admission (95%CI = 0.45%-2.20, P < 0.001) of all nationalities in the study. There was no significant difference in perinatal complications, premature rupture of membrane, placenta previa/accreta, or gestational hypertension/pre-eclampsia between women who delivered vaginally versus by cesarean. Importantly, there were also no significant differences in maternal or neonatal outcomes.
Conclusion: Vaginal delivery was not associated with worse maternal or neonatal outcomes when compared with cesarean. The decision to pursue a cesarean birth should be based on standard indications, not COVID-19 status.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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