BACKGROUND: Besides reducing the quality of obstetric care, the direct impact of COVID-19 on pregnancy and postpartum is uncertain. OBJECTIVE: To evaluate the characteristics of pregnant women deceased due to COVID-19. SEARCH STRATEGY: Cochrane Library, Embase, MEDLINE, Scopus, and Google Scholar were searched from inception to February 2020. SELECTION CRITERIA: Studies that compared deceased and survived pregnant women with COVID-19. DATA COLLECTION AND ANALYSIS: Relevant data were extracted and tabulated. The primary outcome was maternal co-morbidity. MAIN RESULTS: Thirteen studies with 154 deceased patients were included. Obesity doubled the risk of death (relative risk [RR] 2.48, 95% confidence interval [CI] 1.41-4.36, I(2) =0%). No differences were found for gestational diabetes (RR 5.71; 95% CI 0.77-42.44, I(2) = 94%) or asthma (RR 2.05, 95% CI 0.81-5.15, I(2) =0%). Overall, at least one severe co-morbidity showed a twofold increased risk of death (RR 2.26, 95% CI 1.77-2.89, I=76%). Admission to intensive care was related to a fivefold increased risk of death (RR 5.09, 95% CI 2.00-12.98, I(2) =56%), with no difference in need for respiratory support (RR 0.53, 95% CI 0.23-1.48, I(2) =95%) or mechanical ventilation (RR 4.34, 95% CI 0.96-19.60, I(2) =58%). CONCLUSION: COVID-19 with at least one co-morbidity increases risk of intensive care and mortality.
Pregnant women Risk factor COVID-19