Table 1.
Characteristics of the included studies.
| Author | Design | Setting, Country | Population | Objective | Results |
|---|---|---|---|---|---|
| Yang P | Case series | Zhongnan Hospital of Wuhan University, Wuhan, China | 7 pregnant women with COVID-19 7 neonates |
To describe clinical characteristics of neonates born from pregnant women with SARS-CoV-2 | Good outcomes were reported for pregnant women with SARS-CoV-2 and their offspring of neonatal pharyngeal swabs, amniotic fluid samples, and umbilical cord blood samples all tested negative for SARS-CoV-2 by RT-PCR. |
| Paret M | Case report | Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, USA | 1 neonate | To describe clinical characteristics of SARS-CoV-2 infection in febrile infants | No adverse outcomes were reported in neonates with SARS-CoV-2 infection. Encourage routine testing of febrile infants for SARS-CoV-2, even if they lack respiratory symptoms. |
| Li L | Case series | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China | 4 pregnant women with COVID-19 | To describe follow-up characteristics of 4 women already described in the previous article | Pregnant women suffering from pneumonia due to SARS-CoV-2 did not experience severe symptoms or acute respiratory distress syndrome during follow-up (follow-up of Liu D pregnant women) |
| Han MS | Case report | Seoul National University Children’s Hospital, Seoul, Korea, | 1 neonate | To describe the clinical characteristics of COVID-19 in a neonate and her mother; to analyze the viral load of SARS-CoV-2 in clinical specimens from different sources. | SARS-CoV-2 infection did not lead to adverse outcomes in the neonate. SARS- CoV-2 could be shed for a long time in urine and stool. |
| Yang H | Case series | Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. | 13 pregnant women with COVID-19 14 neonates |
To describe the clinical characteristics and outcomes of pregnant women with confirmed SARS-CoV-2 infection | 13 Pregnant women with confirmed SARS-CoV-2 pneumonia experienced mild symptoms or were asymptomatic. All neonates tested for SARS-CoV-2 were negative. Pulmonary CT scan can be used to screen SARS-CoV-2 pregnant women in the outbreak area of SARS-CoV-2 infection. |
| Lowe B | Case report | Gold Coast University Hospital (GCUH), Southport, QLD, Australia | 1 pregnant woman with SARS-CoV-2 1 neonate |
To describe a vaginal birth in a SARS-CoV-2 mother | Vaginal birth in a SARS-CoV-2 patient occurred without complications Rooming-in post-delivery for SARS-CoV-2 positive parents and breastfeeding appears possible and safe when appropriate precautions are taken. |
| Breslin N | Case series | Columbia University Irving Medical Center and Allen Hospital, New York, NY, USA | 43 pregnant women with COVID-19 18 neonates |
To describe the clinical characteristics and outcome of pregnant women with COVID-19 and their neonates | The severity of COVID-19 is similar in pregnant women and non-pregnant adults. Ten women delivered vaginally without any complication. All neonates tested negative for SARS-CoV-2 |
| Liu W | Case series | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China | 19 pregnant women with COVID-19 19 neonates |
To describe the clinical characteristics and outcomes of 19 neonates born to mothers suffered from COVID-19 | RT PCR for SARS-CoV-2 tested negative on all neonatal throat swabs, gastric fluid, urine, feces, amniotic fluid, and umbilical cord blood. No one showed any clinical, radiologic, or biochemical sign of COVID-19. |
| Karami P | Case report | Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran | 1 pregnant woman with COVID-19 1 neonate |
To describe a case of maternal and fetus death in a patient with COVID-19 | A 27-year-old pregnant woman at 30+3 weeks suffering respiratory distress requiring ICU admission and mechanical ventilation. She delivered vaginally after the spontaneous onset of uterine contractions. The neonate was stillborn, with Apgar 0 and did not respond to resuscitation. Lately she developed ARDS, MOF, and finally death. |
| Khan S | Case series | Renmin Hospital of Wuhan University, Wuhan, China | 3 pregnant women with COVID-19 3 neonates |
To describe vaginal birth in SARS-CoV-2-positive mothers | Vaginal delivery was uncomplicated in SARS-CoV-2-positive mothers. All the 3 neonates tested negative for SARS-CoV-2. No vertical transmission of SARS-CoV-2 or intrapartum transmission was found. |
| Xiong X | Case report | Beijing YouAn Hospital, Beijing, China | 1 pregnant woman with COVID-19 1 neonate |
To describe a vaginal birth in a SARS-CoV-2 positive mother | Vaginal birth in a SARS-CoV-2-positive mothers was uncomplicated. Neonate tested negative for SARS-CoV-2. No vertical transmission of SARS-CoV-2 or intrapartum transmission was found. |
| Wu X | Case series | Central Hospital of Wuhan, Wuhan, China | 23 pregnant women with COVID-19 21 neonates |
To describe the clinical characteristics and to study chest CT images in SARS-CoV-2-infected pregnant women | Pregnant and non- pregnant women with SARS-CoV-2 presented similar radiological findings and clinical characteristics. Four of the 21 neonates were negative for SARS-CoV-2 on RT-PCR, 17 were clinically diagnosed as negative. |
| Zhang ZJ | Case series | Data from central government and local healthdepartments, China | 3 pregnant women with COVID-194 neonates with nucleic acid-confirmed SARS-CoV-2 | To describe the clinical characteristics and outcome of neonates with SARS-CoV-2 | Compared with adults, neonates showed milder symptoms and better outcomes. |
| Gidlöf S | Case report | Stockholm, Sweden | 1 pregnant woman with COVID-19 2 neonates |
To describe the clinical characteristics and outcome of a pregnant woman with COVID-19 and her neonates; to ask for liberal testing for SARS-CoV-2 in high-risk patients. | No evidence of vertical transmission. Normal neonatal outcome. |
| Kalafat E | Case report | Ankara, Turkey | 1 pregnant woman with COVID-19 1 neonate |
To describe lung ultrasound role in a pregnant COVID-19 woman | Lung-ultrasound examination is easy and could be useful in pregnant women with COVID-19 All neonatal samples tested negative for SARS-CoV-2 (swabs, cord blood, and placental swab). Mother still in ICU at time of publication. |
| Alonso DÌaz C | Case report | Madrid, Spain | 1 pregnant woman with COVID-9 1 neonate |
To describe the clinical characteristics and outcome of a pregnant woman with SARS-CoV-2 and her neonate | The mother was asymptomatic at delivery, then needed mechanical ventilation in ICU. This is a suspicious case of horizontal transmission, as the initial neonatal SARS-CoV-2 test was negative. Neonate showed mild symptoms. |
| Kamali Aghdam M | Case report | Mousavi Hospital, Zanjan, Iran | 1 neonate | To describe the clinical outcome of an infected neonate | The neonate had positive throat swab and normal chest X-ray. He rapidly improved with oxygen therapy, fluids, antibiotics, and antiviral treatment (Oseltamivir). Discharged on the 6th day. |
| Lee DH | Case report | Daegu Fatimal Hospital, Daegu, South Korea | 1 pregnant woman with COVID-19 1 neonate |
To describe the preventive measures required for delivery in pregnant women with COVID-19 | Mechanical obstruction during labor led to an emergency C-section. Two neonatal throat swab, placental tissue, amniotic fluid sample, and cord blood sample were negative for SARS-CoV-2. |
| Zambrano LI | Case report | Hospital Escuela of Tegucigalpa, Tegucigalpa, Honduras | 1 pregnant woman with COVID-19 1 neonate |
To describe the clinical characteristics and outcome of a pregnant woman with COVID-19 and her neonate | The mother showed mild symptoms. Preterm spontaneous vaginal delivery at 32 occurred. RT-PCR test was negative for SARS-CoV-2 on neonatal throat swab. |
| Zeng L | Case series | Wuhan Children’s Hospital, Wuhan, Hubei, China | 33 neonates born from 33 pregnant women with COVID-19 | To evaluate the clinical outcome of neonates born to SARS-CoV-2-infected pregnant women and the possibility of vertical transmission | 3 neonates out of 33 (9%) had positive swabs for SARS-CoV-2 and early symptoms (one might have been septic) |
| Zeng H | Case series | Zhongnan Hospital of Wuhan University, Wuhan, China | 6 neonates born from 6 pregnant women with COVID-19 | To evaluate the possibility of SARS-CoV-2 vertical transmission | Two neonates had positive IgM, 5 had positive IgG, all 6 had raised IL-6 levels. All neonates had negative RT-PCR tests for SARS-CoV-2 on a throat swab |
| Dong L | Case report | Renmin Hospital of Wuhan University, Wuhan, China | 1 pregnant woman with COVID-19 1 neonate |
To evaluate the possibility of SARS-CoV-2 vertical transmission | Neonate showed IgM and IgG positive, negative RT-PCR tests for SARS-CoV-2 on throat swab. Abnormal levels of the cytokine. Mother had Vaginal swab and breast milk RT-PCR tests for SARS-CoV-2 negative, NP swab positive. |
| Wang J | Case report | Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China | 1 pregnant woman with COVID-19 1 neonate |
To describe the clinical outcome of a SARS-CoV-2-infected neonate with gastrointestinal onset | No exams were performed during the birth or immediately after. Ten days after the birth the mother was found positive. Neonate developed GI symptoms and had both NP and anal swab positive. |
| Wen R | Case report | Qingdao Women and Children’s Hospital, Qingdao, China | 1 pregnant woman with COVID-19 | To describe the clinical outcome of a SARS-CoV-2-infected pregnant woman | Pregnant women with SARS-CoV-2 and non-pregnant adults showed similar clinical characteristics. |
| Liu D | Case series | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China | 15 pregnant women with COVID-19 11 neonates |
To describe the clinical characteristics and outcome of a pregnant woman with COVID-19 and her neonate | The severity of SARS-CoV-2 pneumonia was not affected by pregnancy and delivery in these patients.No stillbirth or abortion were reported. No neonate was infected and suffered asphyxia or death. |
| Fan C | Case series | Renmin Hospital of Wuhan University, Wuhan, China | 2 pregnant women with COVID-19 2 neonates |
To evaluate the possibility of SARS-CoV-2 vertical transmission | Real-time for SARS-CoV-2 on maternal serum, cord blood, placenta tissue, amniotic fluid, vaginal swab, breast milk, and newborn’s nasopharyngeal swab after delivery were negative. Both mothers and newborns had excellent outcomes. |
| Chen R | Case series | Renmin Hospital of Wuhan University, Wuhan, China | 17 pregnant women with COVID-19 17 neonates |
To compare epidural or general anesthesia for C-section delivery in pregnant women with COVID-19; to evaluate the clinical outcome of their newborns | Pregnant COVID-19 women safely received epidural or general anesthesia for Cesarean delivery All neonates tested negative for SARS-CoV-2. |
| Zhu H | Case series | 5 hospitals in Hubei, China | 9 pregnant women with COVID-19 10 neonates |
To evaluate the clinical outcome of infected SARS-CoV-2 pregnant women and the possibility of vertical transmission | Perinatal COVID-19 infection could negatively affect neonates. The authors reported fetal distress, premature labor respiratory distress, thrombocytopenia and even one death. Real-time for SARS-CoV-2 on neonatal pharyngeal swabs showed negative results. |
| Chen H | Case series | Zhongnan Hospital of Wuhan University, Wuhan, China | 9 pregnant women with COVID-19 9 neonates |
To describe the clinical outcome of SARS-CoV-2-infected pregnant women and the possibility of vertical transmission | Pregnant women with SARS-CoV-2 pneumonia and non-pregnant adult patients SARS-CoV-2 pneumonia have similar clinical characteristics. The authors found no evidence of intrauterine infection (amniotic fluid, cord blood, neonatal throat swab, and breast milk all tested negative for SARS-CoV-2). |
| Liu Y | Case series | Hospitals outside of Wuhan (not better defined in the text), China | 13 pregnant women with COVID-19 9 neonates1 stillborn |
To evaluate the clinical outcome of SARS-CoV-2-infected pregnant women and the possibility of vertical transmission | Three Women discharged pregnant; 10 had C-section (emergency in 5 cases), 6 had preterm labor; 1 mother severe case (ARDS+MODS, needed ECMO treatment in ICU, outcome unknown). Neonates: 1 stillborn, 9 well. No evidence of vertical transmission (tests performed not specified). |
| Li Y | Case report | The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. | 1 pregnant woman with COVID-19 1 neonate |
To evaluate the clinical outcome of SARS-CoV-2-infected pregnant woman and the possibility of vertical transmission | No evidence of vertical transmission (feces urine, umbilical cord blood amniotic fluid, placenta, and breast milk samples were negative for RT-PCR for SARS-CoV-2) |
| Wang X | Case report | Affiliated Infectious Hospital of Soochow University, Suzhou, China | 1 pregnant woman with COVID-19 1 neonate |
To evaluate the clinical outcome of SARS-CoV-2-infected pregnant woman and the possibility of vertical transmission | No evidence of vertical transmission. (samples of amniotic fluid, placenta, umbilical cord blood, throat swab, stool, gastric juice of the infant for SARS-CoV-2 RT-PCR tests were negative). |
| Chen S | Case series | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China | 3 pregnant women with COVID-19 3 neonates |
To evaluate the placental features of SARS-CoV-2-infected pregnant women and the possibility of vertical transmission | Tissues from 3 placentas showed no morphological alterations due to SARS-CoV-2 infection: no evidence of vertical transmission (SARS-CoV-2 RT-PCR on neonatal swab were negative). |
| Zeng LK | Case report | Wuhan Children’s Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China. | 1 neonate | To describe the clinical outcome of a SARS-CoV-2-infected neonate | The neonatal symptoms were mild (fever, rhinitis, refuse of feeding). Anal swab positive for SARS-CoV-2 longer than throat swab. |
| Ferrazzi E | Case series | Hospitals in Northern Italy, Italy | 42 pregnant women with COVID-19 42 neonates |
To describe the clinical characteristics and outcome of pregnant women with COVID-19 and their neonates | SARS-CoV-2 syndrome in pregnancy is often mild or moderate. Three SARS-CoV-2 positive newborns (two breastfed without a mask because of post-partum diagnosis and one positive test after vaginal operative delivery). |
| Iqbal SN | Case report | MedStar Washington Hospital Center, Washington, USA | 1 pregnant woman with COVID-19 1 neonate |
To evaluate the clinical outcome of a SARS-CoV-2-infected pregnant woman with vaginal delivery | Vaginal delivery in a SARS-CoV-2-infected mother was uncomplicated. No vertical transmission of SARS-CoV-2 or intrapartum transmission was found. |
| Song L | Case report | Wuhan Union Hospital, Wuhan, China | 1 pregnant woman with COVID-19 1 neonate |
To describe the perioperative management of a pregnant women with COVID-19 who underwent an urgent C-section | Both epidural and spinal and anesthesia during an emergent cesarean delivery were safe. SARS-CoV-2 RT-PCR on neonatal swab at 3 and 7 days of life were negative. |
Abbreviations: COVID-19 (coronavirus disease 2019), SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), RT-PCR (reverse transcriptase-polymerase chain reaction), qRT-PCR (quantitative reverse transcriptase-polymerase chain reaction), CT scan (computed tomography scan), ICU (intensive care unit), CPR (cardiopulmonary resuscitation), ARDS (acute respiratory distress syndrome), MOF (multiple organ failure), C-section (cesarean section), IL-6 (interleukin 6), NP swab (nasopharyngeal swab), GI (gastro-intestinal), MODS (multiple organ dysfunction syndrome), ECMO (extracorporeal membrane oxygenation).