Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Table 2

Characteristics of included studies.

First author’s name	Country		Age (y) (mean or range)	Gestational age			Comorbidities and complications in gestation	Severity of COVID-19	ICU need	Ventilation need	Complications during treatment of COVID-19 ()	Death
				1^st trimester	2^nd trimester	3^rd trimester
Ahmed, I. [60]	United Kingdom	1	29	—	—	1	Obesity, diabetes, renal tubular acidosis, asthma, vitamin D deficiency	Severe	1	1	Pulmonary embolism, basilar artery thrombosis	1
Al-kuraishy, H.M. [84]	Iraq	1	25	—	—	1	None	Nonsevere	—	—	—	—
AlZaghal, L.A. [85]	Jordan	1	30	—	—	1	None	Nonsevere	—	—	—	—
Alzamora, M.C. [86]	Peru	1	41	—	—	1	Obesity, diabetes	Severe	1	1	—	—
An, P. [21]	China	3	25, 31, 33	—	—	3	Not reported	Nonsevere	—	—	—
Anderson, J. [22]	United States	1	35	—	1	—	Obesity, diabetes, asthma	Severe	1	1	ARDS	—
Bani Hani, D.A. [87]	Jordan	1	29	—	—	1	Not reported	Nonsevere	—	—	—	—
Barile, E. [52]	Italy	1	48	—	1	—	Hypertension, obesity, sickle cell trait	Severe	1	1	ARDS	—
Bastug, A. [88]	Turkey	1	20	—	—	1	None	Nonsevere	—	—	—	—
Baud, D. [61]	Switzerland	1	28	—	1	—	Obesity	Nonsevere	—	—	—	—
Blauvelt, CA [23]	United States	1	34	—	—	1	Obesity, asthma, diabetes	Severe	1	1	ARDS	—
Breslin, N. 1 [24]	United States	43	26.9	—	—	43	Obesity (), asthma (), diabetes (), hypertension ()	Severe ()	2	—	Renal insufficiency ()	—
Breslin, N 2 [25]	United States	7	27-39	—	—	7	Obesity (), diabetes (), asthma (), hypertension (), none ()	Severe ()	2	1	Acute kidney injury ()	—
Browne, PC [26]	United States	1	33	—	1	—	Asthma ()	Nonsevere	—	—	—	—
Buonsenso, D. [53]	Italy	4	31, 42, 39, 38	—	2	2	None	Severe ()	1	1	—	—
Cao, D. [89]	China	10	29-35	—	—	10	Diabetes (), preeclampsia (), hypothyroidism (), anemia (), none ()	Nonsevere (10)	—	—	—	—
Carosso, A. [54]	Italy	1	28	—	—	1	Diabetes	Nonsevere	—	—	—	—
Chen, H. [90]	China	9	26-40	—	—	9	Hypertension (), preeclampsia (), none ()	Nonsevere ()	—	—	—	—
Chen, L. [91]	China	118	28-34	22	21	75	Not reported	Nonsevere (), severe ()	1	1	—	—
Chen, R. [122]	China	17	NM	—	—	17	Anemia (), hypertension (), diabetes (), none ()	Nonsevere ()	—	—	—	—
Chen, S. [93]	China	5	25-31	—	—	5	Diabetes (), preeclampsia (), none ()	Nonsevere ()	—	—	—	—
Chen, Y. [94]	China	4	23-34	—	—	4	Cholecystitis (), none ()	Not reported	1	1	—	—
Chhabra, A. [95]	India	1	28	—	—	1	Obesity, diabetes	Nonsevere	—	—	—	—
Cohen, J. [62]	France	88	28-34	Not extractable			Obesity (), diabetes ()	Severe ()	Not reported	Not reported	—	—
Collin, J. [63]	Sweden	13	20-35	Not extractable			Diabetes and obesity (some of the women)	Not reported	13	7	Not reported	—
Cooke, W.R. [64]	United Kingdom	2	39, 28	—	—	2	Obesity (), diabetes ()	Severe ()	2	2	Psychiatric sequelae ()	—
De Socio, GV [55]	Italy	1	33	—	—	1	None	Nonsevere	—	—	—	—
De Castro, A. [56]	Italy	1	34	—	—	1	Autoimmune thyroiditis and mitral regurgitation	Severe	Not reported	Not reported	ARDS, endocarditis, cerebral emboli	—
Dória, M. [65]	Portugal	12	22-41	—	—	12	Chronic hypertension (), asthma (), severe myopia (), ulcerative colitis and psoriasis (), severe scoliosis and Behçet’s syndrome (), none ()	Nonsevere ()	—	—	—	—
Du, Y. [96]	China	1	30	—	—	1	None	Nonsevere	—	—	—	—
Ellington, S. [12]	United States	8207	15-44	Not reported			Diabetes (), lung disease (), cardiovascular (), renal disease (), liver disease (), immunocompromised condition (), neurologic disorders or intellectual disability (), other ()	Asymptomatic ()^a	120^b	42^c	Not reported	16^d
Fan, C. [97]	China	2	34, 29	—	—	2	None ()	Nonsevere ()	—	—	—	—
Fassett, M.J. [27]	United States	17	33.2	—	—	17	Known comorbidities (), none ()	Asymptomatic ()	—	—	—	—
Ferraiolo, A. [57]	Italy	1	30	—	—	1	None	Asymptomatic	—	—	—	—
Fontanella, F. [66]	Netherlands, Ireland	2	39, 29	—	—	2	Obesity (), diabetes (), hepatitis B ()	Nonsevere ()	—	—	Maternal sepsis ()	—
Forero-Peña, D.A. [98]	Venezuela	1	32	—	—	1	None	Nonsevere	—	—	—	—
Fox, N.S. [28]	United States	33	31	Not extractable			Not reported	Asymptomatic (), nonsevere ()	—	—	—	—
Futterman, I. [29]	United States	2	41, 31	—	1	1	None ()	Not reported	1	1	DIC (), ARDS, acute renal failure, sepsis ()	—
Gidlöf, S. [67]	Sweden	1	34	—	—	1	Obesity, diabetes, preeclampsia	Nonsevere	—	—	—	—
Goldfarb I.T., [30]	United States	61	25-38				Obesity (), asthma (), diabetes ()	Not reported	6	4	Not reported	—
González Romero, D. [68]	Spain	1	44	—	—	1	None	Severe	1	1	—	—
Govind, A. [69]	United Kingdom	9	18-39	—	9		Diabetes (), asthma (), none ()	Nonsevere (), severe ()	2	2	Not reported	—
Grimminck, K. [70]	Netherlands	1	31	—	—	1	Hypertension, systemic lupus erythematous	Nonsevere	—	—	—	—
Gulersen, M. [31]	United States	65	29-35	—	65		Known comorbidity (, including asthma, chronic hypertension, diabetes, HIV, and autoimmune disorders), none ()	Asymptomatic (), nonsevere (), severe ()	5	Not reported	Not reported	—
Hantoushzadeh, S. [99]	Iran	9	Not extractable	—	9		Obesity (), underweight (), diabetes (), hypothyroidism (), none ()	Severe ()	9	9	ARDS (), cardiopulmonary collapse (), end organ failure (), acute renal failure (), septic shock and DIC ()	7
Hirshberg, A. [32]	United States	5	27-39	—	2	3	Obesity (), hypertension (), asthma (), diabetes (), chronic kidney disease ()	Severe ()	5	5	—	—
Hong, L. [33]	United States	1	36	—	1	—	Hypothyroidism, obesity, hyperlipidemia	Severe	1	1	—	—
Huang, W. [100]	China	8	27-33	—	—	8	Anemia (), preeclampsia (), none ()	Nonsevere (), severe ()	3	2	Septic shock, cardiomyopathy, ARDS, MODS (), HF, RF, ()	—
Iqbal, S. [34]	United States	1	34	—	—	1	Not reported	Nonsevere	—	—	—	—
Juusela, A. [35]	United States	2	45, 26	—	—	2	Obesity (), polycystic ovary syndrome ()	Not extractable	1	1	Cardiomyopathy ()	—
Kalafat, E. [101]	Turkey	1	32	—	—	1	Thalassemia	Severe	1	1	—	—
Karami, P. [102]	Iran	1	27	—	—	1	None	Severe	1	1	MODS	1
Kayem, G. [71]	France	617	Not reported	—	617		Obesity (), asthma (), diabetes (), gestational hypertension or preeclampsia (), chronic hypertension ()	Nonsevere (), severe ()	Not reported	45	Not reported	1
Kelly, J.C. [36]	United States	1	Not reported	—	—	1	Obesity	Severe	1	1	—	—
Khan, S. [103]	China	3	28, 33, 27	—	—	3	Not reported	Nonsevere	—	—	—	—
Khoury, R. [37]	United States	241	18–47	—	—	241	Not reported	Asymptomatic (), nonsevere (), severe ()	17	9	Not reported	—
Kirtsman, M. [83]	Canada	1	40	—	—	1	Familial neutropenia, diabetes, and frequent bacterial infections	Nonsevere	—	—	—	—
Kuhrt, K. [72]	United Kingdom	1	30	—	—	1	Thyroid carcinoma	Nonsevere	—	—	—	—
Lang, G. [104]	China	1	30	—	—	1	None	Nonsevere	—	—	—	—
Li, N. [105]	China	16	26-37	—	—	16	Diabetes (), gestational hypertension (3), hypothyroidism (2), preeclampsia (1), chronic hypertension (1), polycystic ovary syndrome (1)	Nonsevere ()	—	—	—	—
Li, Y. [106]	China	1	30	—	—	1	Not reported	Nonsevere	—	—	—	—
Liao, X. [107]	China	1	25	—	—	1	Not reported	Nonsevere	—	—	—	—
Liu, D. [108]	China	15	23-40	—	—	11	Thalassemia (), diabetes (), mitral valve and tricuspid valve replacement (), none ()	Nonsevere	—	—	—	—
Liu, H. [109]	China	41	22-42	—	41		Diabetes (), gestational hypertension (), hepatitis B ()	Nonsevere	—	—	—	—
Liu, Y. [110]	China	13	22-36	—	2	11	Not reported	Severe ()	1	1	MODS ()	—
Lokken, E.M. [38]	United States	46	26-34	3	20	23	Diabetes (), asthma (), hypothyroidism (), hypertension (), obese (), underweight (), Crohn’s disease (), heart valve repair (), thyroid carcinoma (), seizure disorder ()	Asymptomatic (), nonsevere (), severe ()	1	—	—	—
London, V. [39]	United States	68	25-34	—	3	65	None (), known comorbidities (, including diabetes (), chronic hypertension (), asthma (), cholestasis (), preeclampsia ())	Asymptomatic (), symptomatic ()	Not reported	1	Not reported	—
Lowe, B. [73]	Australia	1	31	—	—	1	Not reported	Nonsevere	—	—	—	—
Lu, D. [111]	China	1	22	—	—	1	None	Asymptomatic	—	—	—	—
Lucarelli, E. [40]	United States	3	38, 26, 46	—	2	1	Not reported	Severe ()	3	3	Acute kidney injury ()	—
Lyra, J. [74]	Portugal	1	35	—	—	1	None	Nonsevere	—	—	—	—
Martinelli, I. [58]	Italy	1	17	—	—	1	Obesity	Severe	—	—	Pulmonary embolism	—
Martínez-Perez, O. [75]	Spain	82	19-48	—	82		Diabetes (), preeclampsia (), asthma (), hypothyroidism (), other ()	Nonsevere (), severe ()	9	6	Sepsis ()	—
Mehta, H. [41]	United States	1	39	—	1	—	None	Severe	1	1	ARDS	—
Mendoza, M. [76]	Spain	42	26-38	—	42		Diabetes ()	Nonsevere (), severe ()	8	Not reported	Preeclampsia-like syndrome ()	—
Mulvey, J.J. [42]	United States	5	26-40	—	—	5	Polycystic ovary syndrome, iron deficiency anemia (), hypothyroidism (), none ()	Asymptomatic (), nonsevere ()	—	—	—	—
Naqvi, M. [43]	United States	1	35	—	1	—	Hypertension, diabetes, asthma	Severe	—	—	—	—
Nesr, G. [77]	United Kingdom	2	34	—	1	—	Immune thrombocytopenia	Nonsevere	—	—	—	—
Panichaya, P. [112]	Thailand	1	43	—	1	—	None	Nonsevere	—	—	—	—
Peng, Z. [113]	China	1	25	—	—	1	None	Nonsevere	—	—	—	—
Pereira, A. [78]	Spain	60	22-43	10	16	32	HELLP syndrome (), preeclampsia (), DVT ()	Asymptomatic (), nonsevere (), severe ()	1	2	Not reported	—
Pierce-Williams, RMP [44]	United States	64	33.2	—	64		Cardiac disease (including chronic hypertension, cardiomyopathy) (), pulmonary pathology ()	Severe and critical ()	Not reported	24	ARDS (), cardiac arrest ()	—
Prabhu, M. [45]	United States	70	30.5 in symptomatic and 31.4 in asymptomatic (med)	—	70		Chronic hypertension (), preeclampsia or gestational hypertension (), diabetes (), asthma (), obesity ()	Asymptomatic (), symptomatic ()	1	—	Pulmonary edema ()	—
Qadri, F. [5]	United States	16	20-40	—	16		Obesity ()	Nonsevere ()	—	—	—	—
Qiancheng, X. [114]	China	28	30	3	1	24	Hypertension (), diabetes (), hepatitis B (), hypothyroidism ()	Severe ()	Not reported	Not reported	Not reported	—
Rabice, S.R. [46]	United States	1	36	—	—	1	Diabetes, asthma, obesity, preeclampsia	Nonsevere	—	—	Acute pancreatitis	—
Rubin, E.S. [47]	United States	1	26	—	—	1	Chronic hypertension	Nonsevere	—	—	—	—
San-Juan, R. [79]	Spain	32	32	1	9	22	None (), asthma (), obesity (), multiple sclerosis (), diabetes ()	Severe ()	2	2	ARDS ()	—
Savasi, V.M. [59]	Italy	77	15–48	4	13	50^e	Known comorbidities ( including obesity and cardiovascular, autoimmune, endocrine, and metabolic diseases)	Asymptomatic (), severe ()	6	6		—
Schnettler, WT [48]	United States	1	39	—	—	1	Myotonic dystrophy, bicuspid aortic valve, a prior mild cerebrovascular accident	Severe	1	1	ARDS	—
Sentilhes, L. [80]	France	54	19-42	Not extractable			Obesity (), asthma (), chronic hypertension (), other ()	Nonsevere (), severe and critical ()	5	5	ARDS ()	—
Shojaei, S. [115]	Iran	1	38	—	1	—	None	Severe	1	1	Cardiac arrest	1
Silverstein, J.S. [49]	United States	2	17, 34	—	—	2	Obesity ()	Severe ()	2	2	—	—
Sinkey, R.G. [50]	United States	1	25	—	—	1	Hypertension, preeclampsia, obesity, anemia	Not reported	Not reported	—	HF, pulmonary edema	—
Slayton-Milam, S. [51]	United States	1	27	—	—	1	Not reported	Severe	1	1	Worsening anemia	—
Taghizadieh, A. [116]	Iran	1	33	—	—	1	None	Severe	1	1	Acute kidney injury	—
Takemoto, M.L.S. [117]	Brazil	978	29.5 for recovered, 31.5 for died women	Not reported			Cardiovascular (), diabetes (), obesity (), asthma ()	Not reported	207	317	Not reported	124
Tutiya, C.T. [118]	Brazil	2	44, 29	—	—	3	Obesity (), history of breast cancer (), hypertension ()	Severe	2	2	Pulmonary microthrombi	—
Vallejo, V. [8]	United States	1	36	—	—	1	Obesity	Severe	1	1	MODS	1
Vibert, F. [81]	France	1	21	—	1	—	None	Severe	1	1	—	—
Vivanti, A.J. [82]	France	100	29–37	—	100		Asthma (), diabetes (), hypertension ()	Severe ()	10	9	ARDS (), transient hepatitis ()	—
Wang, X. [119]	China	1	28	—	—	1	Not reported	Severe	1	Not reported	—	—
Wang, Z. [120]	China	30	29.9	—	—	30	Hypertension (), diabetes (), hypothyroidism (), obesity ()	Nonsevere ()	Not reported	Not reported	Not reported	—
Wu, C. [121]	China	8	26-35	—	—	8	Not reported	Asymptomatic (), nonsevere ()	—	—	—	—
Wu, X. [122]	China	23	21-37	3	—	20	Hypothyroidism (), hepatitis B (), hypertension (), none ()	Asymptomatic (), nonsevere ()	Not reported	Not reported	Not reported	—
Wu, Y. [123]	China	13	26-40	5	3	5	Not reported	Nonsevere	—	—	—	—
Xia, H. [124]	China	1	27	—	—	1	Not reported	Not reported	Not reported	—	—	—
Xiong, X. [125]	China	1	25	—	—	1	Not reported	Nonsevere	—	—	—
Xu, L. [126]	China	5	23-34	—	—	5	Anemia ()	Nonsevere ()	—	—	—	—
Yan, J. [127]	China	116	24-41	4	6	106	Diabetes (), hypertensive disorders ()	Nonsevere (), severe ()	8	8	—	—
Yang, H. [128]	China	27	22-39	4	—	23	Diabetes (), coagulopathy (), gestational hypertension (), hypothyroidism (), preeclampsia (), hypoproteinemia (), hepatitis (), schistosomiasis ()	Severe ()	—	—	—	—
Yassa, M. [129]	Turkey	8	19-41	3	3	2	Not reported	Not reported	1	Not reported	—	—
Yu, N. [130]	China	7	29-34	—	—	7	Hypothyroidism (), polycystic ovary (), none ()	Not reported	—	—	—	—
Zamaniyan, M. [131]	Iran	1	22	—	—	1	Hypothyroidism	Severe	1	1	ARDS	1
Zambrano, L.I. [132]	Honduras	1	41	—	—	1	Hypertension, hypothyroidism	Nonsevere	—	—	—	—
Zeng, Y. [133]	China	16	25-40	—	—	16	Cardiac disease (), hypothyroidism (), thalassemia ()	Nonsevere ()	Not reported	—	Not reported	—
Zhang, L. [134]	China	18	24-34	—	—	16	Preeclampsia (), diabetes ()	Nonsevere (), severe ()	Not reported	Not reported	—	—

ARDS: acute respiratory distress syndrome; MODS: multiple organ dysfunction syndrome; SCIM: septic-induced ischemic cardiomyopathy; HF: heart failure; RF: respiratory failure; DIC: disseminated intravascular coagulation. ^aData on symptom status were missing for 2852 (35%) pregnant women. ^bA total of 6079 (74%) pregnant women have missing information for ICU admission and were assumed to have not been admitted to an ICU. ^cA total of 6351 (77%) pregnant women have missing information for receipt of mechanical ventilation and were assumed to have not received mechanical ventilation. ^dA total of 3819 (47%) pregnant women have missing information on death and were assumed to have survived. ^e10 patients were postpartum women.