Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country's income status: a meta-analysis. Issue 11 (11th November 2022)

• Record Type: Journal Article
• Authors: Sheikh, Jameela; Lawson, Heidi; Allotey, John; Yap, Magnus; Balaji, Rishab; Kew, Tania; Stallings, Elena; Coomar, Dyuti; Gaetano-Gil, Andrea; Zamora, Javier; Thangaratinam, Shakila
• Other Names: author non-byline.; Fernández-García Silvia author non-byline.; Littmoden Megan author non-byline.; Manning Millie author non-byline.; Banjoko Adeolu author non-byline.; Zhou Dengyi author non-byline.; Attarde Shruti author non-byline.; Gupta Ankita author non-byline.; Ansari Kehkashan author non-byline.; King Yasmin author non-byline.; Sandhu Gurimaan author non-byline.; Akande Damilola author non-byline.; Sambamoorthi Dharshini author non-byline.; Ramkumar Anoushka author non-byline.; Fraser Helen author non-byline.; Hebbar Meghnaa author non-byline.; Maddock Sophie author non-byline.; Rajah Tanisha author non-byline.; Khashaba Alya author non-byline.; Barry Kathryn author non-byline.; Mamey Massa author non-byline.; Chen Wentin author non-byline.; Khalil Halimah author non-byline.; Kostova Elena author non-byline.; Chatterjee Shaunak author non-byline.; Debenham Luke author non-byline.; Llavall Anna Clavé author non-byline.; Dixit Anushka author non-byline.; Lee Siang Ing author non-byline.; Qiu Xiu author non-byline.; Yuan Mingyang author non-byline.; Wely Madelon van author non-byline.; Leeuwen Elizabeth van author non-byline.; Kunst Heinke author non-byline.; Khalil Asma author non-byline.; Tiberi Simon author non-byline.; Brizuela Vanessa author non-byline.; Broutet Nathalie author non-byline.; Kara Edna author non-byline.; Kim Caron Rahn author non-byline.; Thorson Anna author non-byline.; Escuriet Ramón author non-byline.; Oladapo Olufemi T author non-byline.; Mofenson Lynne author non-byline.; Tong Van T author non-byline.; Ellington Sascha author non-byline.; Spiteri Gianfranco author non-byline.; Beaute Julien author non-byline.; Ram Uma author non-byline.; Nair Ajith S author non-byline.; Rayco-Solon Pura author non-byline.; Pardo-Hernandez Hector author non-byline.;
• Is Part Of: BMJ global health. Volume 7:Issue 11(2022)
• Publication Date: 2022-11-11
• Subjects: COVID-19 -- Maternal health; World health -- Periodicals; 362.105
• DOI: 10.1136/bmjgh-2022-010060
• Languages: English
• ISSNs: 2059-7908

Abstract

Abstract : Introduction: The prevalence of COVID-19 and its impact varied between countries and regions. Pregnant women are at high risk of COVID-19 complications compared with non-pregnant women. The magnitude of variations, if any, in SARS-CoV-2 infection rates and its health outcomes among pregnant women by geographical regions and country's income level is not known. Methods: We performed a random-effects meta-analysis as part of the ongoing PregCOV-19 living systematic review (December 2019 to April 2021). We included cohort studies on pregnant women with COVID-19 reporting maternal (mortality, intensive care admission and preterm birth) and offspring (mortality, stillbirth, neonatal intensive care admission) outcomes and grouped them by World Bank geographical region and income level. We reported results as proportions with 95% confidence intervals (CI). Results: We included 311 studies (2 003 724 pregnant women, 57 countries). The rates of SARS-CoV-2 infection in pregnant women varied significantly by region (p<0.001) and income level (p<0.001), with the highest rates observed in Latin America and the Caribbean (19%, 95% CI 12% to 27%; 13 studies, 38 748 women) and lower-middle-income countries (13%, 95% CI 6% to 23%; 25 studies, 100 080 women). We found significant differences in maternal and offspring outcomes by region and income level. Lower-middle-income countries reported significantly higher rates of maternal mortality (0.68%, 95% CI 0.24% to 1.27%; 3 studies, 31 136 women), intensive care admission (4.53%, 95% CI 2.57% to 6.91%; 54 studies, 23 420 women) and stillbirths (1.09%, 95% CI 0.48% to 1.88%; 41 studies, 4724 women) than high-income countries. COVID-19 complications disproportionately affected South Asia, which had the highest maternal mortality rate (0.88%, 95% CI 0.16% to 1.95%; 17 studies, 2023 women); Latin America and the Caribbean had the highest stillbirth rates (1.97%, 95% CI 0.9% to 3.33%; 10 studies, 1750 women). Conclusion: The rates of SARS-CoV-2 infection in pregnant women vary globally, and its health outcomes mirror the COVID-19 burden and global maternal and offspring inequalities. PROSPERO registration number: CRD42020178076.