medigraphic.com
Instituto Nacional de Salud Pública

2021, Número 2

<< Anterior Siguiente >>

salud publica mex 2021; 63 (2)


Covid-19 durante el embarazo: revisión rápida y metaanálisis

Cupul-Uicab LA, Hernández-Mariano JÁ, Vázquez-Salas A, Leyva-López A, Barrientos-Gutiérrez T, Villalobos A

Idioma: Español
Referencias bibliográficas: 47
Paginas: 242-252
Archivo PDF: 394.33 Kb.


RESUMEN

Objetivo. Resumir la evidencia científica sobre efectos maternos y neonatales del Covid-19 durante el embarazo. Material y métodos. Se realizó una revisión rápida Cochrane y un metaanálisis de proporciones y razones de momios (RM). Resultados. Los eventos maternos más comunes fueron la ventilación mecánica invasiva y admisión a la unidad de cuidados intensivos (UCI); las complicaciones del embarazo fueron el sufrimiento fetal y la ruptura prematura de membranas; las comorbilidades fueron la obesidad y el asma. Las cesáreas indicadas por Covid-19 fueron frecuentes (51%). Los eventos neonatales comunes fueron bajo peso y prematuridad; se identificaron neonatos SARS-CoV-2 positivos (14%). Las embarazadas con Covid-19 experimentaron más cesáreas (RM combinada=6.7) y partos pretérmino (RM combinada=2.9); los neonatos experimentaron más admisiones a la UCI neonatal (RM combinada=5.9). Conclusión. La evidencia sobre los efectos adversos del Covid-19 durante el embarazo es limitada. No se pueden descartar riesgos a la salud del binomio, particularmente debido a las cesáreas y prematuridad.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol. 1998;148(11):1094-102. https://doi.org/10.1093/oxfordjournals. aje.a009587

  2. Assiri A, Abedi GR, Al Masri M, Bin Saeed A, Gerber SI, Watson JT. Middle east respiratory syndrome coronavirus infection during pregnancy: a report of 5 cases from Saudi Arabia. Clin Infect Dis. 2016;63(7):951-53. https://doi.org/10.1093/cid/ciw412

  3. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-7. https://doi.org/10.1016/j. ajog.2003.11.019

  4. Saccone G, Carbone FI, Zullo F. The novel coronavirus (2019-nCoV) in pregnancy: What we need to know. Eur J Obstet Gynecol Reprod Biol. 2020;249:92-3. https://doi.org/10.1016/j.ejogrb.2020.04.006

  5. Schwartz DA. An analysis of 38 pregnant women with Covid-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020;144(7):799-805. https://doi.org/10.5858/arpa.2020-0901-SA

  6. Della-Gatta AN, Rizzo R, Pilu G, Simonazzi G. Covid19 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020;223(1):36-41. https://doi.org/10.1016/j.ajog.2020.04.013

  7. Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, Covid 1 -19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020:100107. https://doi.org/10.1016/j.ajogmf.2020.100107

  8. Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (Covid-19) from infected pregnant mothers to neonates: a review. Fetal Pediatr Pathol. 2020;39(3):1-5. https://doi.org/10.1080/15513815.2020.1747120

  9. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe Covid-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020;37(8):861-5. https://doi.org/10.1055/s-0040-1710050

  10. Egloff C, Vauloup-Fellous C, Picone O, Mandelbrot L, Roques P. Evidence and possible mechanisms of rare maternal-fetal transmission of SARS-CoV-2. J Clin Virol. 2020;128:104447. https://doi.org/10.1016/j. jcv.2020.104447

  11. Garritty C, Stevens A, Gartlehner G, King V, Kamel C, Cochrane Rapid Reviews Methods G. Cochrane Rapid Reviews Methods Group to play a leading role in guiding the production of informed high-quality, timely research evidence syntheses. Syst Rev. 2016;5(1):184. https://doi. org/10.1186/s13643-016-0360-z

  12. Cupul-Uicab LA, Hernández-Mariano JÁ, Vázquez-Salas RA, Leyva- López A, Barrientos-Gutiérrez T, Villalobos A. Material suplementario. Github, 2020 [citado septiembre, 2020]. Disponible en: https://github.com/ repositoriosr/Repositorio_Embarazo_Covid19.git

  13. Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health. 2014;72(1):39. https:// doi.org/10.1186/2049-3258-72-39

  14. Higgins JPT, Green S (eds). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. London: The Cochrane Collaboration, 2011 [citado septiembre 2020]. Disponible en: www.handbook.cochrane.org

  15. Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with Covid-19 pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41. https://doi.org/10.1093/cid/ ciaa352

  16. Liao J, He X, Gong Q, Yang L, Zhou C, Li J. Analysis of vaginal delivery outcomes among pregnant women in Wuhan, China during the Covid-19 pandemic. Int J Gynaecol Obstet. 2020(1):53-7. https://doi.org/10.1002/ ijgo.13188

  17. Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental Pathology in Covid-19. Am J Clin Pathol. 2020;150(1):53-7. https:// doi.org/10.1093/ajcp/aqaa089

  18. Blitz MJ, Grünebaum A, Tekbali A, Bornstein E, Rochelson B, Nimaroff M, et al. Intensive care unit admissions for pregnant and non-pregnant women with Covid-19. Am J Obstet Gynecol. 2020;223(2):290-1. https:// doi.org/10.1016/j.ajog.2020.05.004

  19. Collin J, Byström E, Carnahan A, Ahrne M. Pregnant and postpartum women with SARS-CoV-2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 2020;99(7):819-22. https://doi.org/10.1111/aogs.13901

  20. Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis. 2020;95:376-83. https:// doi.org/10.1016/j.ijid.2020.04.065

  21. Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical Covid-19 in hospitalized pregnancies: a US cohort study. Am J Obstet Gynecol MFM. 2020;2(3):100134. https://doi.org/10.1016/j.ajogmf.2020.100134

  22. Savasi VM, Parisi F, Patanè L, Ferrazzi E, Frigerio L, Pellegrino A, et al. Clinical findings and disease severity in hospitalized pregnant women with coronavirus disease 2019 (Covid-19). Obstet Gynecol. 2020;136(2):252-8. https://doi.org/10.1097/aog.0000000000003979

  23. London V, McLaren R, Jr., Atallah F, Cepeda C, McCalla S, Fisher N, et al. The relationship between status at presentation and outcomes among pregnant women with Covid-19. Am J Perinatol. 2020;37(10):991-4. https://doi.org/10.1055/s-0040-1712164

  24. Khodamoradi Z, Boogar SS, Shirazi FKH, Kouhi P. Covid-19 and acute pulmonary embolism in postpartum patient. Emer Infect Dis. 2020;26(8):1937-9. https://doi.org/10.3201/eid2608.201383

  25. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian SE, et al. Maternal death due to Covid-19 disease. Am J Obstet Gynecol. 2020; 223(1):109. https://doi.org/10.1016/j.ajog.2020.04.030

  26. Karami P, Naghavi M, Feyzi A, Aghamohammadi M, Novin MS, Mobaien A, et al. Mortality of a pregnant patient diagnosed with Covid-19: A case report with clinical, radiological, and histopathological findings. Travel Med Infect Dis. 2020. https://doi.org/10.1016/j.tmaid.2020.101665

  27. Vallejo V, Ilagan JG. A postpartum death due to coronavirus disease 2019 (Covid-19) in the United States. Obstet Gynecol. 2020;136(1):52-5. https://doi.org/10.1097/aog.0000000000003950

  28. Wu X, Sun R, Chen J, Xie Y, Zhang S, Wang X. Radiological findings and clinical characteristics of pregnant women with Covid-19 pneumonia. Int J Gynaecol Obstet. 2020;150(1):58-63. https://doi.org/10.1002/ijgo.13165

  29. Baud D, Greub G, Favre G, Gengler C, Jaton K, Dubruc E, Pomar L.. Second-trimester miscarriage in a pregnant woman with SARSCoV- 2 infection. JAMA. 2020;323(21):2198-200. https://doi.org/10.1001/ jama.2020.7233

  30. Wu Y, Liu C, Dong L, Zhang C, Chen Y, Liu J, et al. Coronavirus disease 2019 among pregnant Chinese women: Case series data on the safety of vaginal birth and breastfeeding. BJOG. 2020;127(9):1109-115. https://doi. org/10.1111/1471-0528.16276

  31. Coronado-Munoz A, Nawaratne U, McMann D, Ellsworth M, Meliones J, Boukas K. Late-onset neonatal sepsis in a patient with Covid-19. N Engl J Med. 2020;382(19):e49. https://doi.org/10.1056/NEJMc2010614

  32. Kamali-Aghdam M, Jafari N, Eftekhari K. Novel coronavirus in a 15-dayold neonate with clinical signs of sepsis, a case report. Infect Dis (Lond). 2020;52(6):427-9. https://doi.org/10.1080/23744235.2020.1747634

  33. Lorenz N, Treptow A, Schmidt S, Hofmann R, Raumer-Engler M, Heubner G, Konstantin G. Neonatal early-onset infection with SARS-CoV-2 in a newborn presenting with encephalitic symptoms. Pediatr Infect Dis J. 2020;39(8):e212. https://doi.org/10.1097/inf.0000000000002735

  34. Yang H, Hu B, Zhan S, Yang LY, Xiong G. Effects of SARS-CoV-2 infection on pregnant women and their infants: A retrospective study in Wuhan, China. Arch Pathol Lab Med. 2020;144(10):1217-222. https://doi. org/10.5858/arpa.2020-0232-SA

  35. Li J, Wang Y, Zeng Y, Song T, Pan X, Jia M, et al. Critically ill pregnant patient with Covid-19 and neonatal death within two hours of birth. Int J Gynaecol Obstet. 2020;150(1):126-8. https://doi.org/10.1002/ijgo.13189

  36. Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy.J Infect. 2020. https://doi. org/10.1016/j.jinf.2020.02.028

  37. Lokken EM, Walker CL, Delaney S, Kachikis A, Kretzer NM, Erickson A, et al. Clinical characteristics of 46 pregnant women with a SARS-CoV-2 infection in Washington State. Am J Obstet Gynecol. 2020;223(6):911. https://doi.org/10.1016/j.ajog.2020.05.031

  38. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60. https://doi.org/10.21037/tp.2020.02.06

  39. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with Covid-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi. org/10.1016/S0140-6736(20)30566-3

  40. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, Zheng C. Pregnancy and perinatal outcomes of women with coronavirus disease (Covid-19) pneumonia: a preliminary analysis. AJR Am J Roentgenol. 2020;215(1):127-32. https://doi.org/10.2214/ajr.20.23072

  41. Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z. Clinical characteristics of 19 neonates born to mothers with Covid-19. Front Med. 2020;14:193-8. https://doi.org/10.1007/s11684-020-0772-y

  42. Kasraeian M, Zare M, Vafaei H, Asadi N, Faraji A, Bazrafshan K, Roozmeh S. Covid-19 pneumonia and pregnancy; a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2020:1-8. https://doi.org/10.1 080/14767058.2020.1763952

  43. Sanchis-Gomar F, Lavie CJ, Mehra MR, Henry BM, Lippi G. Obesity and outcomes in Covid-19: when an epidemic and pandemic collide. Mayo Clin Proc. 2020;95(7):1445-53. https://doi.org/10.1016/j.mayocp.2020.05.006

  44. Álvarez-López DI, Espinoza-Molina MP, Cruz-Loustaunau ID, Álvarez- Hernández G. La diabetes e hipertensión arterial como factores asociados con la letalidad por Covid-19 en Sonora, México, 2020. Salud Publica Mex. 2020;62(5):456-7 [citado septiembre, 2020]. Disponible en: https://saludpublica. mx/index.php/spm/article/view/11546

  45. Zimmermann P, Curtis N. Covid-19 in children, pregnancy and neonates: a review of epidemiologic and clinical features. Pediatr Infect Dis J. 2020;39(6):469-77. https://doi.org/10.1097/INF.0000000000002700

  46. Yang Z, Liu Y. Vertical transmission of severe acute respiratory syndrome coronavirus 2: a systematic review. Am J Perinatol. 2020;37(10):1055- 60. https://doi.org/10.1055/s-0040-1712161

  47. Velasco-Reyna R, Hernández-Ávila M, Méndez-Santa Cruz JD, OrtegaÁlvarez MC, Ramírez-Polanco EA, Real-Ornelas GA. Criterios de retorno al trabajo y determinación del valor de vulnerabilidad por Covid-19. Salud Publica Mex. 2021;63:136-46. https://doi.org/10.21149/11984




2020     |     www.medigraphic.com