Interpretation
Studies of influenza, severe respiratory distress syndrome, and Middle
East respiratory syndrome due to coronaviruses show that these
pathologies increase maternal and perinatal morbidity and mortality.6–11,27 Even the total number of pregnant women with
these diseases is less than that reported in this study, so it seems
unlikely that our findings will change significantly.
Some specific findings we can highlight from this review are that the
severity and mortality in pregnant women is less than in general
population but very similar with the age group. 28–30The clinical findings are very similar to the rest of the population,28,29,31 and, in addition, the diagnosis of pulmonary
pathology in pregnant woman is basically made with computed tomography.
Interestingly one third of this population had lymphopenia. It was
observed even in patients without symptoms of the disease26, this laboratory finding could be considered when
the infection by coronavirus-19 is observed in pregnant women.
It is noteworthy that the use of antivirals, chloroquine, and
Lopinavir-Ritonavir is very low in this pregnant population
(<5%); however, the use of antivirals was more than 50%
after birth. The need for mechanical ventilation was very low, which
suggests that pregnant patients, despite being a higher-risk population,
tend not to be complicated despite the disease; it is worthwhile to
continue investigating to determine if this is it true or not.
In the obstetric part, it is interesting that about 10% are complicated
by premature rupture of the membranes, a percentage three times higher
when compared to the general population 32. Also, we
must highlight that one out of four pregnant women ended their pregnancy
prematurely; however, it was not a cause of perinatal mortality,
possibly because most of them were late preterm. Perinatal mortality is
low, and the evolution is very good, despite the presence of pneumonia
in one out of 10 newborns.
This review found no association or evidence of vertical transmission of
the coronavirus-2019 at birth. Four infants who had a positive test,
however those tests were made more than 36 hours after birth16,22 and proving it with antibodies also raises
questions. 33