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. 2021 Jan 18;18:10. doi: 10.1186/s12978-021-01070-6

Table 1.

Studies included in the scoping review

Author, Year Title Type of article Topic Geographic area of focus Sample size Conclusions
Delahoy, September 2020 “Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19” MMWR, population surveillance of 13 states Direct effects on pregnancy United States 598 Pregnant women might be at increased risk for severe coronavirus disease
Wu et al. June 2020 “Clinical Manifestation and Laboratory Characteristics of SARS-CoV-2 Infection in Pregnant Women.” Peer-reviewed, retrospective study Direct effects on pregnancy China 8 Close monitoring of laboratory parameters including the WBC count, LYMPH count, and CRP, along with other imaging features in chest CT scans, is warranted to promptly prevent, diagnose, and treat a SARS-CoV-2 infection during pregnancy
Xu et al. April 2020 “Clinical Presentations and Outcomes of SARS-CoV-2 Infected Pneumonia in Pregnant Women and Health Status of Their Neonates.” Peer reviewed, retrospective study Direct effects on pregnancy, intrauterine transmission China 5 No obvious vertical transmission was observed, lymphopenia and eosinopenia were observed more frequently in pregnant COVID-19 patients as compared to pregnant women without COVID-19
Smith et al. June 2020 “Maternal and Neonatal Outcomes Associated with COVID-19 Infection: A Systematic Review.” Peer reviewed, systematic review Direct effects on pregnancy, intrauterine transmission, labor and delivery China N/A COVID-19-positive pregnant women present with fewer symptoms than the general population and may be RT-PCR negative despite having signs of viral pneumonia. The incidence of preterm births, low birth weight, C-section, NICU admission appear higher than the general population
Knight et al. June 2020 “Characteristics and Outcomes of Pregnant Women Admitted to Hospital with Confirmed SARS-CoV-2 Infection in UK: National Population Based Cohort Study.” Peer reviewed, population cohort study Direct effects on pregnancy, intrauterine transmission United Kingdom 427 Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation
Allotey et al. September 2020 “Clinical Manifestations, Risk factors, and Maternal and Perinatal Outcomes of Coronavirus Disease 2019 in Pregnancy: Living Systematic Review and Meta-analysis” Peer reviewed, systematic review and meta-analysis Direct effects on pregnancy Global 11,432 Pregnant and recently pregnant women are less likely to manifest COVID-19 related symptoms of fever and myalgia than non-pregnant women of reproductive age and are potentially more likely to need intensive care treatment for COVID-19. Pre-existing comorbidities, high maternal age, and high body mass index seem to be risk factors for sever covid-19. Preterm birth rates are high in pregnant women with covid-19 than in pregnant women without the disease
Pereira et al. July 2020 “Clinical Course of Coronavirus Disease-2019 in Pregnancy.” Peer reviewed, retrospective study Direct effects on pregnancy, intrauterine transmission, labor and delivery, breastfeeding and infant contact Spain 60 Most of the pregnant women with COVID‐19 had a favorable clinical course. However, one‐third of them developed pneumonia, of whom 5% presented a critical clinical status. Seventy‐eight percent of the women had a vaginal delivery. No vertical or horizontal transmissions were diagnosed in the neonates during labor or breastfeeding
Blitz et al. June 2020 “Maternal Mortality among Women with Coronavirus Disease 2019 Admitted to the Intensive Care Unit.” Peer reviewed, case series Direct effects on pregnancy New York, United States 462 Maternal death occurred in 15% of patients admitted to the ICUs for COVID-19 and in 25% of those who required invasive mechanical ventilation. Delivery occurred in half of the patients with COVID-19 who were admitted to the ICUs and all patients who required invasive mechanical ventilation. Hispanic women constituted the largest racial or ethnic group in the study, which may reflect a disproportionate burden of disease among minority groups
Chen et al. March 2020 “Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: A Retrospective Review of Medical Records.” Peer reviewed, retrospective study Direct effects on pregnancy, intrauterine transmission, labor and delivery, breastfeeding and infant contact China 9 The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy
Yang et al. April 2020 “Clinical Features and Outcomes of Pregnant Women Suspected of Coronavirus Disease 2019.” Peer reviewed, prospective case control study Direct effects on pregnancy China 55 The clinical symptoms and laboratory indicators are not obvious for asymptomatic and mild COVID-19 pregnant women. Pulmonary CT scan plus blood routine examination are more suitable for finding pregnancy women with asymptomatic or mild COVID-19 infection, and can be used screening COVID-19 pregnant women in the outbreak area of COVID-19 infection
Khan et al. March 2020 “Impact of COVID-19 Infection on Pregnancy Outcomes and the Risk of Maternal-to-Neonatal Intrapartum Transmission of COVID-19 during Natural Birth.” Letter to the editor, case series Direct effects on pregnancy, labor and delivery China 3 None of the 3 women in this study had died of COVID-19 infection as of March 1, 2020. No vertical transmission of COVID-19 was found in the third trimester of pregnancy among infants delivered via the vaginal route. Moreover, we did not find evidence of maternal-to-neonatal intrapartum transmission of COVID-19 via vaginal delivery
Lokken et al. May 2020 “Clinical Characteristics of 46 Pregnant Women with a Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Washington State.” Peer reviewed, retrospective study Direct effects on pregnancy Washington, United States 46 Severe coronavirus disease 2019 developed in approximately 15% of pregnant patients and occurred primarily in overweight or obese women with underlying conditions. Obesity and coronavirus disease 2019 may synergistically increase risk for a medically indicated preterm birth to improve maternal pulmonary status in late pregnancy. These findings support categorizing pregnant patients as a higher-risk group, particularly those with chronic comorbidities
Savasi et al. August 2020 “Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19).” Peer reviewed, prospective cohort study Direct effects on pregnancy Italy 77 One in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease
Mendoza et al. June 2020 “Pre-Eclampsia-like Syndrome Induced by Severe COVID-19: A Prospective Observational Study.” Peer reviewed, prospective cohort study Direct effects on pregnancy Spain 42 Pregnant women with severe COVID‐19 can develop a PE‐like syndrome that might be distinguished from actual PE by sFlt‐1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre‐eclampsia with caution
Ferraiolo et al. June 2020 “Report of Positive Placental Swabs for SARS-CoV-2 in an Asymptomatic Pregnant Woman with COVID-19.” Peer reviewed, case report Intrauterine transmission Italy 1 This was a report of a positive placental swab for SARS-CoV-2 in an asymptomatic woman in the third trimester of pregnancy with a positive rhino-pharyngeal swab for COVID-19, who underwent an urgent caesarian section for obstetric indications
Hosier et al. 2020 “SARS-CoV-2 Infection of the Placenta.” Peer reviewed, case report Direct effects on pregnancy, intrauterine transmission United States 1 This report highlights a case of acute placental infection with SARS–CoV-2 that may have potentiated severe, early-onset preeclampsia
Golden, Thea, & Simmons, July 2020 “Maternal and Neonatal Response to COVID-19.” Peer reviewed, scoping review Intrauterine transmission Global N/A At this time, vertical transmission of SARS-CoV-2 is considered unlikely
Huntley et al. August 2020 “Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection: A Systematic Review.” Peer reviewed, systematic review Direct effects on pregnancy, intrauterine transmission, labor and delivery Global N/A There are low rates of maternal and neonatal mortality and vertical transmission with SARS-CoV-2. The preterm birth rate of 20% and the cesarean delivery rate exceeding 80% seems related to geographic practice patterns
Walker et al. June 2020 “Maternal Transmission of SARS-COV-2 to the Neonate, and Possible Routes for Such Transmission: A Systematic Review and Critical Analysis.” Peer reviewed, systematic review Intrauterine transmission, labor and delivery, breastfeeding and infant contact Global 655 Neonatal COVID‐19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother
Zhang et al. July 2020 “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Late Pregnancy: A Report of 18 Patients from Wuhan, China Peer reviewed, case series Direct effects on pregnancy, intrauterine transmission, labor and delivery China 18 The majority of patients in late term pregnancy with COVID-19 were of ordinary type, and they were less likely to develop into critical pneumonia after early isolation and antiviral treatment. Vertical transmission of SARS-CoV-2 was not detected, but the proportion of neonatal bacterial pneumonia was higher than other neonatal diseases in newborns
Martins-Filho et al. April 2020 “To Breastfeed or Not to Breastfeed? Lack of Evidence on the Presence of SARS-CoV-2 in Breastmilk of Pregnant Women with COVID-19.” Peer reviewed, rapid systematic review Breastfeeding and infant contact Global N/A No breast milk samples were positive for SARS-CoV-2 and, to date, there is no evidence on the presence of SARS-CoV-2 in breast milk of pregnant women with COVID-19
Perrone et al. May 2020 “Lack of Viral Transmission to Preterm Newborn from a COVID-19 Positive Breastfeeding Mother at 11 Days Postpartum.” Peer reviewed, case report Breastfeeding and infant contact Italy 1 During a stay in the hospital, mother and healthcare caregivers applied recommended hygiene measures, consisting of wearing surgical‐mask, hand washing, and using alcohol‐based solutions to clean the surfaces. In this setting, no horizontal transmission occurred. Moreover, RT‐PCR assay for SARS‐CoV‐2 performed on breast milk during mother febrile peak was negative. This is in line with recent studies, RT‐PCR assays on breast milk samples collected from affected women result negative for SARS‐CoV‐2
Zeng et al. March 2020 “Antibodies in Infants Born to Mothers With COVID-19 Pneumonia.” Peer reviewed, research letter Breastfeeding and infant contact China 6 Among 6 mothers with confirmed COVID-19, SARS-CoV-19 was not detected in the serum or throat swab by RT-PCR in any of their newborns. However, virus-specific antibodies were detected in neonatal blood sera samples
Dong et al. May 2020 “Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn.” Peer reviewed, research letter Intrauterine transmission, breastfeeding and infant contact China 1 A neonate born to a mother with COVID-19 had elevated antibody levels and abnormal cytokine test results 2 h after birth. The elevated IgM antibody level suggests that the neonate was infected in utero
Kimberlin, David & Stagno, March 2020 “Can SARS-CoV-2 Infection Be Acquired In Utero?: More Definitive Evidence Is Needed.” Peer reviewed, editorial Intrauterine transmission, breastfeeding and infant contact Global N/A More definitive evidence is needed before concluding that fetuses are at risk from congenital infection with SARS-CoV-2
Egloff et al. July 2020 “Evidence and Possible Mechanisms of Rare Maternal–Fetal Transmission of SARS-CoV-2.” Peer reviewed, review Intrauterine transmission France 179 Among 179 newborns tested for SARS-CoV2 at birth from mothers with COVID-19, transmission was suspected in 8 cases, 5 with positive nasopharyngeal SARS-CoV-2 RT-PCR and 3 with SARS-CoV-2 IgM
Wu et al. May 2020 “Coronavirus Disease 2019 among Pregnant Chinese Women: Case Series Data on the Safety of Vaginal Birth and Breastfeeding.” Peer reviewed, single center cohort study Intrauterine transmission, breastfeeding China 13 Vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination
Ashokka et al. July 2020 “Care of the Pregnant Woman with Coronavirus Disease 2019 in Labor and Delivery: Anesthesia, Emergency Cesarean Delivery, Differential Diagnosis in the Acutely Ill Parturient, Care of the Newborn, and Protection of the Healthcare Personnel.” Peer reviewed, clinical opinion Labor and delivery Global N/A We present management strategies derived from best available evidence to provide guidance in caring for the high-risk and acutely ill parturient
Oxford-Horrey et al. August 2020 “Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19.” Peer reviewed, review Labor and delivery U.S N/A Guidelines from various clinical societies, along with direction from local health authorities, must be considered when approaching the care of an obstetric patient with known or suspected COVID-19. With a rapidly changing landscape, a simplified and cohesive perspective using guidance from different clinical society recommendations regarding the critically-ill obstetric patient with COVID-19 is needed
Gatta, Nunzia, Rizzo, Pilu & Simonazzi, April 2020 “COVID19 during Pregnancy: A Systematic Review of Reported Cases.” Peer reviewed, systematic review Labor and delivery Global 51 At the time of the report, 3 pregnancies were ongoing; of the remaining 48 pregnant women, 46 gave birth by cesarean delivery, and 2 gave birth vaginally
Zaigham & Andersson, April 2020 “Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies.” Peer reviewed, systematic review Labor and delivery Global 108 91% of the women were delivered by cesarean section
Chen et al. April 2020 “Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China.” Letter to the editor, review Labor and delivery China 118 Of the 68 patients who delivered during the study period, 63 (93%) underwent a cesarean section
Malhotra et al. June 2020 “No Change in Cesarean Section Rate during COVID-19 Pandemic in New York City.” Letter to the editor Labor and delivery U.S N/A We found that there were no changes in Cesarean section rate during the COVID-19 pandemic in New York City
COVIDSurg Collaborative, May 2020 “Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans” Peer reviewed, modelling study Labor and delivery Global N/A Globally, 81.7 per cent of operations for benign conditions,37.7 per cent of cancer operations and 25.4 per cent of elective caesarean sections would be cancelled or postponed
Narang et al. May 2020 “SARS-CoV-2 in Pregnancy: A Comprehensive Summary of Current Guidelines.” Peer reviewed, summary of guidelines Labor and delivery Global N/A The summary of guidelines for the management of COVID-19 in pregnancy across different perinatal societies is fairly consistent, with some variation in the strength of recommendations
Lei et al. March 2020 “Clinical Characteristics of COVID-19 in Pregnancy: Analysis of Nine Cases.” Retrospective case study Breastfeeding and infant contact China 9 Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina
Wang et al. July 2020 “A Case Report of Neonatal 2019 Coronavirus Disease in China.” Peer reviewed, case study Breastfeeding and infant contact China 1 The mother’s breast milk sample was negative for SARS-CoV-2 as well
Zhu et al. June 2020 “Breastfeeding Risk from Detectable Severe Acute Respiratory Syndrome Coronavirus 2 in Breastmilk.” Peer reviewed, retrospective case study Breastfeeding and infant contact China 5 Four out of five (80%) patient`s breastmilk samples were negative for SARS-CoV-2 RT-PCR, which is similar to previous observations,2,8 while one (20%) patient`s (Patient 3) breastmilk showed SARS-CoV-2 RNA test positive
Dong et al. January 2020 “Antibodies in the Breast Milk of a Maternal Woman with COVID-19.” Peer reviewed, case study Breastfeeding and infant contact China 1 A maternal woman was positive for SARS-CoV-2 tested in throat swabs but negative tested in other body fluids, and she had IgG and IgA detected in breast milk
Bastug et al. July 2020 “Virolactia in an Asymptomatic Mother with COVID-19.” Peer reviewed, case study Breastfeeding and infant contact Turkey 1 Temporary separation of the newborn from a mother with confirmed or suspected COVID-19 should be strongly considered to reduce the risk of transmission to the neonate
Wu et al. August 2020 “Perinatal Depressive and Anxiety Symptoms of Pregnant Women during the Coronavirus Disease 2019 Outbreak in China.” Peer reviewed, multicenter, cross-sectional study Mental health China 4124 Pregnant women assessed after the declaration of coronavirus disease 2019 epidemic had significantly higher rates of depressive symptoms than women assessed before the epidemic declaration. These women were also more likely to have thoughts of self-harm. The depressive rates were positively associated with the number of newly confirmed cases of coronavirus disease 2019, suspected infections, and deaths per day
Saccone et al. May 2020 “Psychological Impact of Coronavirus Disease 2019 in Pregnant Women.” Peer reviewed, cross-sectional survey study Mental health Italy 100 The COVID-19 outbreak had a moderate to severe psychological impact on pregnant women
Jungari, June 2020 “Maternal Mental Health in India during COVID-19.” Peer reviewed, letter to the editor Mental health India N/A Pregnant women and new mothers are at an elevated risk of suffering from mental health problems. It has been observed that the uncertainty surrounding COVID-19 has led to higher levels of depression among women during and after pregnancy
Gausman & Langer, April 2020 “Sex and Gender Disparities in the COVID-19 Pandemic.” Peer reviewed, commentary Mental health Global N/A Although containment strategies … may be clinically important to reduce transmission, they may also have profound short- and long-term mental health implications for women
Aryal & Pant, December 2020 “Maternal Mental Health in Nepal and Its Prioritization during COVID-19 Pandemic: Missing the Obvious.” Peer reviewed, letter to the editor Mental health Nepal N/A Lack of counseling, uncertainty and indecisiveness increases stress during pregnancy. In addition to this, pregnant women are worrying about COVID19 effects on their health and their newborns
Kotabagi, Fortune, Essien, Nauta, & Yoong, July 2020 “Anxiety and Depression Levels among Pregnant Women with COVID-19.” Peer reviewed, letter to the editor Mental health UK N/A Median score rose to a maximum at the height of the pandemic deaths in the UK when “lockdown” rules were instituted amid great uncertainty about National Health Service capacity and COVID outcomes
Chivers et al. Septermber 2020 “Perinatal Distress During COVID-19: Thematic Analysis of an Online Parenting Forum” Peer reviewed, qualitative thematic analysis Mental health Australia N/A Themes were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed
Koenen, July 2020 “Pregnant During a Pandemic?” Blog article Mental health U.S N/A Over 70% of women report clinically significant depression or anxiety, and over 40% screen positive for post-traumatic stress disorder (PTSD)
Thapa, Mainali, Schwank, & Acharya, July 2020 “Maternal Mental Health in the Time of the COVID-19 Pandemic.” Peer reviewed, editorial Mental health Global N/A Strict public health measures directed towards mitigating the spread of disease are necessary but known to have negative psychological effects leading to stress, anger and confusion
Preis et al. December 2020 “Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic” Peer reviewed, survey Mental health, Prenatal care U.S 4451 Nearly one-third of pregnant women highly stressed by the COVID-19 pandemic
Roberton et al. May 2020 “Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study” Peer reviewed, modelling study Prenatal care Global N/A Model estimates a reduction in antenatal care by at least 18%, and possibly up to 51.9%, and a similar reduction in postnatal care
Menendez et al. May 2020 “Avoiding Indirect Effects of COVID-19 on Maternal and Child Health.” Peer reviewed, comment Prenatal care Global N/A In the context of the COVID-19 pandemic, some African countries are changing routine ANC guidelines to space (and de facto reduce) the number of contacts to one every 3 months instead of monthly visits, or delaying the postpartum visit to 3 months after delivery (therefore no longer constituting a postpartum visit)
Ramoni, June 2020 “How COVID-19 Is Affecting Antenatal Care.” News article Prenatal care Nigeria N/A Dr. Adeyemi Okunowo, admitted that with COVID-19, the normal way of caring for pregnant women had been modified to reduce the spread of the disease
Aryal, Shrestha, May 2020 “Motherhood in Nepal during COVID-19 Pandemic: Are We Heading from Safe to Unsafe?” Comment Prenatal care Nepal N/A There is a possibility of delay in seeking care when pregnant mothers are unsure when to visit the hospitals because of the uncertainty of availability of their services during the pandemic. For women hailing from remote areas, the travel ban during the lockdown causes a delay in reaching care
Pallangyo et al. June 2020 “The Impact of Covid-19 on Midwives’ Practice in Kenya, Uganda and Tanzania: A Reflective Account.” Peer reviewed, reflective account Prenatal care Kenya, Uganda, and Tanzania N/A Midwives have reported low numbers attending maternal health clinics and women are afraid to visit the hospitals for fear of contracting coronavirus… This has led to women coming into hospitals too late, sometimes ending with undesirable outcomes e.g. stillbirths, neonatal and maternal death
Population Council, April 2020 “Kenya: COVID-19 Knowledge, Attitudes, Practices and Needs—Responses from Second Round of Data Collection in Five Nairobi Informal Settlements (Kibera, Huruma, Kariobangi, Dandora, Mathare).” Survey Prenatal care, gender equity in the workforce Kenya 1,769

More women reported complete loss of income/employment compared to men. Women were twice

as likely to forgo essential health services, including family planning services

ReliefWeb, April 2020 “Rapid Gender Analysis—COVID-19: West Africa—April 2020—Benin.” Analysis Prenatal care West Africa 266 Between social distancing slowing down all service provisions and the fear of attending clinics, it is very hard for women to access SRHR services. Women and youth have little access to traditional information channels like TV and radio because men control these outlets in the household
Semaan et al. June 2020 “Voices from the Frontline: Findings from a Thematic Analysis of a Rapid Online Global Survey of Maternal and Newborn Health Professionals Facing the COVID-19 Pandemic.” Peer reviewed, global, cross-sectional study Prenatal care Global 714 Healthcare providers are worried about the impact of rapidly changing care practices on health outcomes: reduced access to antenatal care, fewer outpatient visits, shorter length of stay in facilities after birth, banning birth companions, separating newborns from COVID-19 positive mothers and postponing routine immunizations
Coxon et al. September 2020 “The Impact of the Coronavirus (COVID-19) Pandemic on Maternity Care in Europe.” Peer reviewed, editorial Prenatal care U.K N/A Concern about what constitutes safe care of pregnant women and newborns has increased, and in many settings, risk averse decisions have been taken in maternity care provision which, it is argued, may increase unnecessary medical interventions, put women at risk of being infected with COVID-19 by reducing provision of community or home-based care, and reduce or reverse progression towards high quality maternity care
Ayenew et al. June 2020 “Risk for Surge Maternal Mortality and Morbidity during the Ongoing Corona Virus Pandemic.” Preprint Prenatal care India and Ethiopia N/A Lockdown and quarantine secondary to COVID-19 pandemic could have serious consequences for women's health more than ever. Poor accessibility and low literacy rate to use it is another challenge to implementation telemedicine in developing countries
Stevis-Gridneff, Haridasani Gupta, Monica Pronczuk “Coronavirus Created an Obstacle Course for Safe Abortions.” News article Healthcare Infrastructure Europe N/A For many women in Europe seeking abortions, the COVID-19 pandemic added another obstacle in an already complicated and time-sensitive course
Frederisken, June 2020 “State Action to Limit Abortion Access During the COVID-19 Pandemic.” News article Healthcare Infrastructure U.S N/A The response to the COVID-19 pandemic has prompted several states to place restrictions that have effectively banned or blocked the availability of abortion services
UNFPA, April 2020 “Impact of the COVID-19 Pandemic on Family Planning and Ending Gender-Based Violence, Female Genital Mutilation and Child Marriage.” Report Healthcare Infrastructure Global N/A

If the lockdown continues for 6 months and there are major service disruptions due to COVID-19, an additional

7 million unintended pregnancies are expected to occur

International Planned Parenthood Federation, April 2020 “COVID-19 Pandemic Cuts Access to Sexual and Reproductive Healthcare for Women around the World” News article Healthcare Infrastructure Global N/A 5,633 static and mobile clinics and community-based care outlets have already closed because of the outbreak, across 64 countries. They make up 14% of the total service delivery points IPPF members ran in 2018
Gettleman & Raj, July 2020 “8 Hospitals in 15 h: A Pregnant Woman’s Crisis in the Pandemic.” News article Healthcare Infrastructure India N/A Her baby was coming, and her complications were growing more dangerous. But nowhere would take her — an increasingly common story as India’s health care system buckles under pressure
Kumari, Mehta, & Choudhary, July 2020 “COVID-19 outbreak and decreased hospitalisation of pregnant women in labour.” Peer reviewed, retrospective analysis Healthcare Infrastructure India N/A Our initial analysis of women admitted during the lockdown period revealed a 43·2% reduction in hospitalisation compared with the control period and a 49.8% reduction compared with the same calendar period from the previous year. Referred obstetric emergencies also decreased by 66.4%
Takemoto et al. July 2020 “Maternal Mortality and COVID-19.” Peer reviewed, systematic review Healthcare Infrastructure Brazil 20 Barriers to access healthcare, differences in pandemic containment measures in the country and high prevalence of concomitant risk factors for COVID-19 severe disease may play a role in the observed disparity compared to worldwide reports on maternal outcomes
Rafaeli & Hutchinson, June 2020 “The Secondary Impacts of COVID-19 on Women and Girls in Sub-Saharan Africa” Preprint, rapid review Healthcare Infrastructure Sub-Saharan Africa N/A

There is strong evidence to suggest that women and girls in SSA

will suffer from extreme and multifaceted negative secondary impact as a result of the

COVID-19 crisis

Khalil et al. July 2020 “Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic” Peer reviewed, retrospective study Healthcare Infrastructure U.K 3399 The incidence of stillbirth was significantly higher during the pandemic period (none associated with COVID-19) than during the prepandemic period
KC et al. August 2020 “Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: A prospective observational study” Peer reviewed, prospective observational study Healthcare Infrastructure Nepal 21,763 The institutional stillbirth rate increased from 14 per 1000 total births before lockdown to 21 per 1000 total births during lockdown, and institutional neonatal mortality increased from 13 per 1000 livebirths to 40 per 1000 livebirths
Shuchman, May 2020 “Low- and Middle-Income Countries Face up to COVID-19.” News article Healthcare Infrastructure Global N/A On and off the front lines, doctors are watching in alarm as COVID-19 hits areas with vulnerable populations and fragile healthcare systems. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas, expects the pandemic to exact a bigger toll in the Global South than in North America or Europe, for several reasons
Bong et al. April, 2020 “The COVID-19 Pandemic: Effects on Low- and Middle-Income Countries.” Peer reviewed, research summary Healthcare infrastructure Global N/A In the absence of specific, effective treatment and given a lack of resources in managing active COVID-19 patients, prevention and early containment of the disease appear to be the most feasible option for LMICs
Hupaku & Petrongolo, 2020 “COVID-19 and Gender Gaps: Latest Evidence and Lessons from the UK.” Peer reviewed, research-based policy analysis and commentary Gender equity in the workforce United Kingdom N/A The social distancing and lockdowns associated with the COVID-19 crisis has hit service sectors with frequent interactions between consumers and providers which cannot be done from home. At the same time, it has added education and childcare services to pre-existing home production needs
Robertson & Gebeloff, April, 2020 “How Millions of Women Became the Most Essential Workers in America.” Newspaper article Gender equity in the workforce United States N/A Though deemed “essential workers” during the COVID-19 pandemic, female healthcare workers face inequality with regards to wages, resource allocation, and general respect and prestige compared to their male counterparts
Jankowski et al. May, 2020 “Risk Stratification for Healthcare Workers during CoVID-19 Pandemic: Using Demographics, Co-Morbid Disease and Clinical Domain in Order to Assign Clinical Duties.” Preprint literature review Gender equity in the workforce Global N/A We have generated a tool which can provide a framework for objective risk stratification of doctors and health care professionals during the COVID-19 pandemic
World Health Organization, March, 2020 “Shortage of Personal Protective Equipment Endangering Health Workers Worldwide.” News release Gender equity in the workforce Global N/A To meet rising global demand for personal protective equipment (PPE), WHO estimates that industry must increase manufacturing by 40 per cent
Alon et al. 2020 “The Impact of COVID-19 on Gender Equality.” Working paper Gender equity in the workforce United States N/A The economic downturn caused by the current COVID-19 outbreak has substantial implications for gender equality, both during the downturn and the subsequent recovery
Johnston, Mohammed, & van der Linden, 2020 “Evidence of Exacerbated Gender Inequality in Child Care Obligations in Canada and Australia During the COVID-19 Pandemic.” Peer reviewed, research article Gender equity in the workforce Canada & Australia 7746 Households in Canada and Australia have exhibited similar trends in the gendered allocation of additional child care responsibilities resulting from policy responses to the COVID-19 pandemic
Malik & Naeem, 2020 “Impact of COVID-19 Pandemic on Women: Health, livelihoods & domestic violence.” Peer reviewed, policy review Gender equity in the workforce Pakistan N/A The government should map out a plan of action to counter the short and long-term effects of the coronavirus on women keeping in view their health, livelihoods, and domestic violence
UN Women, May, 2020 The Private Sector's Role in Mitigating the Impact of COVID-19 on Vulnerable Women and Girls in Nigeria Peer reviewed, research brief Gender equity in the workforce Eastern and Southern Africa N/A The Nigerian private sector has assumed a leading role in the fight against the COVID-19 pandemic in the country. CACOVID aimed to also help mobilize private sector thought leadership, raise public awareness and buy-in for COVID-19 prevention, and provide direct support to strengthen the healthcare sector’s capacity to respond to the crisis
Wahome, April, 2020 “Impact of Covid-19 on Women Workers in the Horticulture Sector in Kenya. Hivos.” Peer reviewed, action-oriented rapid assessment summary report Gender equity in the workforce Nairobi 71

The impact of Covid-19 pandemic has impacted women workers in the horticulture sector socially, economically and psychologically,

with the effect spiraling to their homes

World Vision International Cambodia, June, 2020 “Rapid Assessment of the impact of COVID-19 on child wellbeing in Cambodia Summary Report.” Peer reviewed, rapid assessment summary report Gender equity in the workforce Cambodia 222 households, 42 key informant interviews, 65 agricultural cooperative leaders The COVID-19 outbreak is already having a severe impact on livelihood, food security, and education, especially among the most vulnerable families in Cambodia
Staff of the National Estimates Branch, July, 2020 “Current Employment Statistics Highlights.” Peer reviewed, detailed industry employment analysis Gender equity in the workforce United States N/A During the time period of the COVID-19 pandemic, different industries saw both increases and decreases in employment
Adams-Prassl, et al. April, 2020 “Inequality in the Impact of the Coronavirus Shock: Evidence from Real Time Surveys. IZA Discussion Papers.” Discussion paper Gender equity in the workforce United Kingdom, United States, and Germany 20,910 The labor market impacts of COVID-19 differ considerably across countries. Within countries, the impacts are highly unequal and exacerbate existing inequalities. Workers in alternative work arrangements and in occupations in which only a small share of tasks can be done from home are more likely to have reduced their hours, lost their jobs and suffered falls in earnings. Less educated workers and women are more affected by the crisis
Viveiros & Bonomi, June, 2020 “Novel Coronavirus (COVID-19): Violence, Reproductive Rights and Related Health Risks for Women, Opportunities for Practice Innovation” Peer reviewed, commentary Domestic violence Global Now is the time for violence prevention leaders to advocate for bold action. This includes prioritizing the needs of women (especially minoritized women) in medical, social and legal settings using innovative intervention and service engagement (e.g., e-filing for protection orders, virtual advocacy services), urging policy makers to pass legislation to support women, and shining an accountability spotlight on leadership
Wanqing, March, 2020 “Domestic Violence Cases Surge During COVID-19 Epidemic.” Magazine article Domestic violence China N/A Rates of domestic violence in China increased during the COVID-19 pandemic, many of which were attributable to the epidemic itself, but due to the focus on the pandemic, the needs of victims were neglected
Euronews, March, 2020 “Domestic Violence Cases Jump 30% during Lockdown in France.” News article Domestic violence France N/A Domestic violence cases in France increased following the onset of a nationwide lockdown due to COVID-19
UN Women, April, 2020 “COVID-19 and Ending Violence against Women and Girls. Issue brief Domestic violence Global N/A It is critical to address the increase of violence against women during COVID-19 through accelerated and concerted e orts of governments, international and national civil society organizations and UN agencies. The needs of women and girls who face multiple forms of discrimination need to be prioritized
Sigal, et al. April, 2020 “‘Another Pandemic’: In Latin America, Domestic Abuse Rises amid Lockdown.” News article Domestic violence Latin America N/A Lockdowns around Latin America are helping slow the spread of COVID-19, but are having a darker and less-intended consequence: a spike in calls to helplines suggests a rise in domestic abuse, in a region where almost 20 million women and girls suffer sexual and physical violence each year
Graham-Harrison, et al. March, 2020 “Lockdowns around the World Bring Rise in Domestic Violence.” News article Domestic violence Global N/A Domestic violence against women and children has increased as a result of the quarantine during the COVID-19 pandemic
Bosman, August, 2020 “Domestic Violence Calls Mount as Restrictions Linger: ‘No One Can Leave.’” Newspaper article Domestic violence United States N/A The coronavirus has created new tensions. Staying at home has worsened abusive situations. Shelters worry about the spread of the virus
Women’s Safety NSW, April, 2020 “New Domestic Violence Survey in NSW Shows Impact of COVID-19 on the Rise.” Peer reviewed, media release Domestic violence Australia 80 Surveys of frontline women’s domestic violence workers during the COVID-19 pandemic reveal increased overall clients utilizing their services, increased complexity of client needs, escalated or worsened violence, increased violence specifically relating to COVID-19, and increased violence reported for the first time
Ndedi, April, 2020 “Framework in Ending Violence Against women and Girls with the Advent of the COVID 19 from an African Perspective.” Evidence-based framework Domestic violence Africa N/A There is a need to increase of knowledge and awareness-support for community mobilization. It is also important to engage with telecom mobile companies to deliver messages and provide services like interventions challenging violent masculinities and CSOs advocacy on ending gender-based violence with the COVID-19. Finally, the provision of quality essential services adapted to the current pandemic context is essential
Mukherjee et al. June, 2020 “Vulnerability of Major Indian States Due to COVID-19 Spread and Lockdown.” Analysis of state- and national- level health data sources Domestic violence India N/A There are many states in India, including Gujarat, that have a higher percentage of women experiencing domestic violence with drunkard husband as compared to the national average. The lockdown is likely to affect these sections of women much adversely as they are locked at home with their abusers who are likely to get more violent in the absence of liquor. The National Commission for Women (NCW) on 17th April, 2020 said it registered 587 domestic violence complaints between March 23 and April 16—a significant surge from 396 complaints received in the previous 25 days between February 27 and March 22
DeBolt et al. November 2020a “Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls.” Peer reviewed, multicenter, retrospective, case–control study Direct effects on pregnancy 38 U.S Pregnant women with severe and critical coronavirus disease 2019 are at an increased risk for certain morbidities when compared with nonpregnant controls
Zambrano et al. October 2020a “Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status—United States, January 22–October 3, 2020” MMWR population, surveillance Direct effects on pregnancy 400,000 U.S In an analysis of approximately 400,000 women aged 15–44 years with symptomatic COVID-19, intensive care unit admission, invasive ventilation, extracorporeal membrane oxygenation, and death were more likely in pregnant women than in nonpregnant women

a Study added in after September 11 to reflect updates in the knowledge.