Neonatal outcomes among pregnant women with COVID-19: a systematic scoping review and meta-analysis

Current findings on the neonatal outcomes among pregnant women infected with COVID-19 remain inconclusive. The purpose of this systematic scoping review and meta-analysis was to summarize the literature regarding this topic and provide an overview of the methodologies and results present in current research. PubMed was searched up to December 2022 to identify observational studies that reported neonatal outcomes among children delivered by mothers diagnosed with COVID-19 during pregnancy. Outcomes of interest included vertical transmission to neonates, neonatal intensive care unit (NICU) admission, and neonatal death. Qualitative analysis and meta-analysis were applied to summarize and synthesize the results. Out of an initial selection of 13,387 studies, 187 were included in this systematic scoping review. There was high heterogeneity in the epidemiologic study design, sample size, and outcomes of interest. Most studies focused on neonatal outcomes from birth to day 14 rather than the full neonatal period. Conflicting conclusions were drawn regarding outcomes among neonates delivered by COVID-19-positive mothers. Results of meta-analysis revealed that maternal COVID-19 infection was moderately associated with the risk of vertical transmission to neonates (Incidence Rate [IR], 2.66%; 95%CI, 2.11–3.35%), neonatal intensive care unit admission (IR, 16.43%; 95%CI, 14.59–18.45%), and neonatal death (IR, 1.29%; 95%CI, 0.95–1.74%), and these risks seemed to be increased with the severity of maternal COVID-19. This review identified heterogeneity in the epidemiologic studies. Maternal COVID-19 infection was associated with the risk of adverse neonatal outcomes and these risks seemed to be increased with the severity of maternal COVID-19.