Jurnal Aisyah: Jurnal Ilmu Kesehatan

Volume 7, Issue S1, 2022, p. 253–262

ISSN 2502-4825 (print), ISSN 2502-9495 (online)

Pregnancy and Covid 19 Infection: Characteristics, Signs,

Symptoms, and Impact on Maternal and Neonatal: Systematic
Review
Yuni Purwatiningsih*1); Sinta Dewi Lestyoningrum1; Aliesya Patricia Wulandari2
1*)
Research Organization for Health National Research and Innovation Agency
2
Faculty of Medicine University Brawijaya Indonesia

ARTICLE INFO ABSTRACT

The Covid 19 pandemic had a terrible impact on the health system,
Article history: especially maternal and child health. Covid 19 and MERS infections lead to
higher case fatality rates and more severe morbidity during pregnancy.
Received 11 March 2021
Accepted 21 June 2022 Pregnant women and neonates are a group at risk for the severity of Covid
Published 10 July 2022 19 infection. This study aimed to review the characteristics, signs,
symptoms, and impact on maternal and neonatal of pregnant women with
positive Covid 19. We performed a systematic review to investigate
Keyword: pregnant women infected with Covid 19. Literature research was conducted
Covid 19 using several search engines, including Pub Med, Science Direct, and The
SARS CoV-2 Lancet, from January 1st, 2021 to March 31th, 2022. The articles were
Pregnancy screened based on the inclusion and exclusion criteria based on the PRISMA
Maternal Outcome guidelines. We included 8 studies, the number of pregnant women obtained
Neonatal Outcome was 1460 pregnant women with positive COVID 19, 1830 pregnant women
with negative COVID-19, and 71 non pregnant women with positive Covid
19. The average age of the mother is around 19-41 years, gestational age is
between 25-41 weeks, and the common symptoms are fever, cough,
difficulty breathing, or shortness of breath. The most common
complications were premature birth and premature rupture of membranes;
besides bleeding complications, preeclampsia and fetal distress were
reported. The common symptoms are fever and cough, and the impact of
maternal are preterm birth and premature rupture of the membranes. The
effect of neonatal is low birth weight and premature.

This open access article is under the CC–BY-SA license.

Kata kunci:
ABSTRAK
Covid 19 Pandemi Covid 19 memberikan dampak yang sangat buruk bagi sistem
SARS CoV-2 kesehatan, khususnya untuk kesehatan ibu dan anak. Infeksi Covid 19 dan
Kehamilan MERS menyebabkan tingkat kematian kasus yang lebih tinggi dan tingkat
Dampak Maternal
morbiditas yang lebih parah selama kehamilan. Ibu hamil dan neonatus
Dampak Neonatal
merupakan kelompok yang berisiko untuk terjadinya infeksi Covid-19 yang
berat. Penelitian ini bertujuan untuk mengkaji karakteristik, tanda, gejala,
*) corresponding author
dan dampak pada ibu dan bayi baru lahir dari ibu hamil yang positif Covid
Yuni Purwatiningsih 19. Penelitian merupakan systematic review yang dilakukan untuk
Research Center for Public Health and menyelidiki ibu hamil yang terinfeksi Covid 19. Penelitian ini dilakukan
Nutrition, Research Organization for Health, dengan melakukan pencarian literatur menggunakan beberapa database
National Researchand Innovation Agency pencarian elektronik, antara lain Pub Med, Science Direct, dan The Lancet
yang dipublikasi pada satu tahun terakhir yaitu mulai 1 Januari 2021 dan 31
Email: [email protected] Maret 2022. Artikel yang diperoleh dilakukan screening berdasarkan
DOI: 10.30604/jika.v7iS1.1182
kriteria inklusi dan eksklusi berdasarkan pedoman PRISMA. Terdapat 8
artikel penelitian yang kami masukkan kedalam penelitian ini yang telah
Copyright @author(s)
sesuai dengan kriteria inklusi, jumlah ibu hamil yang didapat adalah 1460
ibu hamil positif COVID 19 dan 1830 ibu hamil negatif COVID-19. Rata-rata

Available online at: https://aisyah.journalpress.id/index.php/jika/

Email: [email protected]
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7 (S1), 2022, – 254
Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

usia ibu sekitar 19-41 tahun, usia kehamilan antara 25-41 minggu, dan
gejala yang umum adalah demam, batuk, sulit bernapas, atau sesak napas.
Komplikasi yang paling umum adalah kelahiran prematur dan ketuban
pecah dini, selain dari komplikasi perdarahan, preeklamsia dan gawat janin
juga dilaporkan. Gejala yang umum adalah demam dan batuk, dan dampak
dari ibu adalah kelahiran prematur dan ketuban pecah dini. Efek neonatus
adalah berat badan lahir rendah dan prematur.

This open access article is under the CC–BY-SA license.

INTRODUCTION METHOD

The Covid 19 pandemic that began in 2019 was first This research is systematic review research by taking
discovered in Wuhan, China, which had a terrible impact on data from scientific journals published in the last 1 year,
the health system. (Wenling et al. 2020) This virus is very starting from January 1, 2021, to March 31, 2022. Literature
easily transmitted through droplets or airborne.(Harrison, research was conducted using several search engines,
Lin, and Wang 2020) Common symptoms are fever, cough, including Pub Med, Science Direct, and The Lancet. Search
sore throat, malaise, myalgia, gastrointestinal symptom, using keywords “Covid 19” or “SARS CoV-2” and
anosmia, and ageusia. (Gandhi, Lynch, and del Rio 2020) This “Pregnancy” or “Maternal” or “Neonatal” and “Effect” or
virus attack all age groups, including pregnant women, “Outcome” or ”Impact”. The articles obtained from the
neonates, and newborn. Pregnant women and neonates are a three search databases were then checked for duplication
group at risk for the severity of Covid 19 infection. One of the using the Mendeley reference manager. Articles that were no
physiological changes that occur during pregnancy is the longer duplicated were then screened based on the inclusion
immune system in pregnant women. Changes in the immune and exclusion criteria based on the PRISMA guidelines.
system of pregnant women occur due to the body The inclusion criteria of this study are studies that report
responding to pregnancy which is considered a foreign pregnant women infected with COVID-19 and report
object that must be handled. Therefore the body's response characteristics and impacts on maternal and/or neonatal,
produces large amounts of cytokine protein, coupled with either analytical or descriptive studies, retrospective or
the presence of Covid 19 infection. Covid 19 infection in prospective cohort study designs, case series, case-control,
pregnancy can impact the profile of Cytokines in pregnant observational and cross-sectional, published articles January
women, cytokine levels in pregnant women appear to 2021-March 2022 in Indonesian and English which can be
correlate with the severity of Covid 19 disease. (Tanacan et downloaded in full text. The exclusion criteria for this study
al. 2021) were non-pregnant COVID-19 infection, articles that did not
SARS CoV 2 and MERS infections lead to higher case report characteristics, maternal and/or neonatal impacts,
fatality rates and more severe morbidity during pregnancy. articles using the literature review method, systematic
(Schwartz and Graham 2020) Any infection that occurs reviews, editorial reviews, correspondence, scoping reviews,
during pregnancy has a potential risk, including infection integrated reviews, and articles in the form of guidelines and
with Covid 19, based on recent research saying that 3% of opinions, articles in languages other than Indonesian and
pregnant women infected with SARS-CoV-2 require English. The flow of the literature search can be seen in
intensive care. (Zimmermann and Curtis 2020) Very few Figure 1.
pregnant women diagnosed with Covid 19 gave birth The search results for articles that have gone through the
normally, and more gave birth by cesarean section; this selection are then reviewed using the narrative method.
indicates that the complication rate for pregnant women Articles that meet the criteria are summarized, including the
infected with COVID 19 is higher. (Villar et al. 2021). researcher’s name, year of publication, research methods,
Several systematic review studies related to COVID-19 and research results covering characteristics, signs,
infection in pregnancy have been carried out and show that symptoms, and maternal and neonatal impact. Furthermore,
the symptoms commonly experienced by pregnant women the review results are analyzed according to the research
are fever and cough. (Do Amaral et al. 2020; Smith et al. objectives, then look for similarities and differences in each
2020) There is much understanding of the impact of covid 19 research result from each selected article, then discussed and
infection on pregnancy, differences in other populations and concluded.
risk of vertical transmission from the mother and baby.
(Alzamora et al. 2020) In previous systematic reviews, there
were no reports of maternal deaths due to covid 19 infection.
(Smith et al. 2020) Currently, Covid 19 infection continues to RESULTS AND DISCUSSION
increase in various cities in the world, and this requires the
latest research related to the characteristics of pregnant The results of this study were obtained from 3 databases
women infected with covid 19 and its impact on mothers PubMed, Science Direct, and The Lancet from January 1,
and babies to be able to provide an overview and guidelines 2021, to January 31, 2022. After a search, 524 articles were
in handling covid 19 for pregnant women and newborns, found in PubMed, 1090 articles in Science Direct, and 52 in
therefore, research this article will explain the the lancet, with a total of 1666 articles. Of the 1666 articles,
characteristics, signs, and symptoms as well as the impact of duplication was checked using the Mendeley reference
Covid 19 on pregnancy on maternal and neonatal through a manager, and 168 duplicated articles were obtained, 1498
systematic review study. articles were selected for selection, conformity with the
inclusion criteria, topics, and research objectives through the

Jurnal Aisyah: Jurnal Ilmu Kesehatan ISSN 2502-4825 (print), ISSN 2502-9495 (online)
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Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

selection of article titles, and there were 1360 articles maternal and neonatal impacts, 1 article with reproductive
excluded, 138 articles were carried out a feasibility study age population, 2 articles did not report the characteristics of
based on abstracts, and 119 articles were excluded, then 19 pregnant women and 4 articles in the form of guidelines and
articles were then carried out a full-text review, there were opinions. So that 8 articles were found that were suitable
11 articles excluded including 4 articles that did not contain and further analysis and discussion were carried out.

Records identified from :

Identification

Records removed before the screening:

PubMed = 524 Duplicate records removed (n = 168)
Science Direct = 1090
Lancet = 52
Total n = 1666 articles
Articles excluded (n = 1360)

*Languages other than English or Indonesia : 108

*literature review, systematic review, editorial
Articles screened review,
(n = 1498 ) correspondence, scoping review, integrated review :
Screening and Eligibility

276
*Not associated with Covid 19 infection in pregnancy
and neonates: 976
Articles sought for retrieval
(n =138 ) Articles not retrieved
(n = 119)

Full text articles assessed for Articles excluded (n = 11)

eligibility (n =19 ) *The article does not cover the impact on maternal and
neonatal (n = 4)
*The population is of reproductive age, not only
pregnant women (n = 1 )
*The article does not report the characteristics of
Included

pregnant women with positive COVID-19 (n = 2 )

Studies included in systematic review
Article guideline and opinion (n = 4)
(n = 8)

Figure 1. Systematic Review Flow Diagram Based on PRISMA 2020

Table 1
Summary of Selected Studies

Author (Year) Title Study Design Population Main Finding

Nayak, et al. Neonatal outcomes of Prospective Neonatal was born to Characteristics of a mother are the
(2021) pregnant women with Observational SARS - CoV 2 infected most deliveries section Cesaria
COVID-19 in a Study mothers (n=165), (63,6%), the average gestational are
developing country Pregnant women 37,5 week. Out of 37 symptomatic
setup invected Covid 19 (n mothers of Covid 19, 21 had
=162) breathing difficulties and required
oxygen. There was one maternal
death and 5 neonatal death from the
mother with positive covid 19 one of
them with positive covid 19. The
most outcome of neonatal are low
birth weight (29,7%) and preterm
baby (16,4%)
A.Almatary,et Clinical outcomes of Retrospective Pregnant women The characteristic of pregnant
al.(2021) maternal and neonate Cohort with confirmed women in this study are the median
with COVID-19 Covid-19 infection age was 30 years, and the median
infection: A multicenter and their neonates gestational age was 38 weeks. Two-
study in Saudi Arabia (n: 288) thirds of deliveries occur by vaginal
delivery. Most pregnant women
developed Covid 19 symptoms, the
most prevalent symptom was cough
(31,9). About 9,4% of pregnant
women need respiratory support.
Most pregnancy outcomes were
premature (15,5%) follow by fetal
distress (6,5%), preeclampsia (2,0%),
and one pregnant woman died.86
neonates required NICU care, three of
them had IUGR. There was no
neonatal death, however there are 4
fetal death during the pregnancy.
M. Abedzadeh- Clinical and obstetric Case series study Pregnant women The characteristic of pregnant
Kalahroudi ,et al. characteristics of with confirmed women in this study is the mean age
(2021) pregnant women with Covid-19 infection (n: of pregnant women was 30,6 ± 6,5
Covid-19: A case series 26) years. The mean gestational age of

Pregnancy and Covid 19 Infection: Characteristics, Signs, Symptoms, and Impact on Maternal and Neonatal: Systematic Review
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7 (S1), 2022,– 256
Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

Author (Year) Title Study Design Population Main Finding

study on 26 patients the patients at admission and
delivery was 31.8 ± 5.2 and 36.3 ± 3.4
weeks. The most type delivery was
cesarean section (69,2%). The most
common symptom was fever and
chills (96,2%). The most mater no
fetal outcome was preterm labor
(38%), preeclampsia (19,2%). Of 26
newborns, six cases were admitted
to the NICU and 2 neonatal death.
Daclin,et al.(2022 Impact of Covid-19 Case control Pregnant women In the Covid 19 group there were
infection in pregnancy study with confirmed 27,5% asymptomatic and 72,5%
and neonates: A case Covid-19 infection (n: symptomatic, the most common
control study 86) and Pregnant symptom were fever and cough. The
women with negative most type of delivery was
Covid-19 (n : 86) spontaneous delivery (56,5%).
Neonatal outcomes were not
statistically different between the
two groups. There was no maternal
and neonatal death.
Arinkan,et Perinatal outcomes of Prospective Pregnant women There was no significant difference in
al.(2021 pregnant women observational with confirmed Covid characteristic gestational age at birth
having SARS-CoV-2 study 19 (n: 46) and between pregnant women who had
infection healthy pregnant Covid 19 infection and those who did
women (n: 70) not (37.02 ± 5.85 vs 38.5 ± 2.33). The
most common symptom was cough
(41,3%). The most pregnancy
outcome was preterm delivery. There
were three emergency cesarean
sections and two of them died due to
Covid 19. One newborn had a
positive result for Covid 19.
C,Ferrugini,et SARS-CoV-2 infection Cros sectional Pregnant women Most pregnant women were aged 20
al.(2021) in pregnant women Study with Covid 19 to 34 years old. The most frequently
assisted in a high-risk infection (n: 265) reported symptoms were runny
maternity hospital in nose, cough, loss of smell and taste,
Brazil: Clinical aspects headache, and fever. There was also a
and obstetric outcomes 35% rate of asymptomatic infections
and a 4.6% rate of severe or critical
infections. The most outcome of
pregnancy was preterm delivery,
cesarean section and resuscitation.
J.Villar, et Maternal and Neonatal Cohort Study Pregnant women The characteristics of pregnant
al.(2021) Morbidity and with Covid 19 women in this study are not different
Mortality Among infection (n: 706) from the two groups, however 48,6%
Pregnant Women With Pregnant women of pregnant women with Covid 19
and Without Covid-19 without Covid 19 had been overweight early in
Infection infection (n: 1424) pregnancy. Women with Covid 19
had a higher rate of hypertension,
preeclampsia and infection. Eleven
women died due to Covid 19
infection (159/10.000 births). 41% of
women with Covid -19 diagnosis
were Asymptomatic. The most
common symptom was fever and
shortness of breath. Women with
Covid 19 infection had a higher
cesarean delivery rate. They also
have higher preterm birth and fetal
distress and higher low birth weight
rate (RR,1,58:95% CI). The rates of pre
labour rupture of membranes were
similar in both groups.
M.S, Asghar, et.al COVID-19 infection Retrospective Pregnant women The characteristic of pregnant
(2022) among pregnant and Cohort Study with Covid 19 women in this study is the mean age
non-pregnant women: infection (n : 60) and lower than non pregnant women.
Comparison of non pregnant women The most common symptom was
biochemical markers with Covid 19 fever, fatigue, and cough. Mortality
and out comes during infection (n: 71) rates were 5,0 % in pregnant women
COVID-19 pandemic, A versus 15,5% in non pregnant

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Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

Author (Year) Title Study Design Population Main Finding

retrospective cohort women. The pregnancy outcome was
study preeclampsia, premature birth, and
stillbirth. Most typesof deliveries
were cesarean sections.

Based on the selection of articles that have been carried out 8 requires an emergency birth, a cesarean section is the best
articles were obtained and then analyzed qualitative and option. (Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S,
narrative. The total number of pregnant women obtained was Biswas A, Choolani M, Mattar C 2020) A comprehensive
3290 pregnant women, 1460 pregnant women with positive review and meta-analysis of generally high-quality studies
COVID 19, 1759 pregnant women with negative COVID-19 as with suitable comparison groups indicated that pregnant
control groups, and 71 non pregnant women with positive Covid women with SARS-CoV-2 infection had a higher risk of
19 as a control groups. The total neonates reported from this
preeclampsia, preterm birth, and stillbirth than those who
study were 605 neonates, 71 neonates were positive for covid
did not have SARS-CoV-2 disease. (Wei et al. 2021) When
19, and others were not screened. Selected studies came from
compared to those with a mild condition, severe COVID-19
hospitals in various countries, including India, Saudi Arabia, Iran,
Parisian, Turkey, Brazil, Pakistan, and one study involved 18 was linked to preeclampsia, premature birth, gestational
countries, including Argentina, Brazil, Egypt, France, Ghana, diabetes, and low birth weight in pregnant women.(Jamieson
India, Indonesia, Italy, Japan, Mexico, Nigeria, North Macedonia, & Rasmussen, 2021).
Pakistan, Russia, Spain, Switzerland, the UK, and the US. The Complications in pregnant women who are positive for
average age of the mother is around 19-41 years, gestational age COVID-19 are PROM, premature birth, and fetal distress.
is between 25-41 weeks, and the symptoms that generally (Ferrugini et al. 2022) In neonates, the most common
appear are fever, cough, difficulty breathing, or shortness of complications are low birth weight and premature birth.
breath. The most common complications were premature birth Based on the results of the literature study, it was found that
and premature rupture of membranes; besides bleeding there were more than 15 cases of maternal death due to
complications, preeclampsia and fetal distress were reported. COVID-19 infection and more than 3 cases of neonatal death
The most complications in newborns were premature and low from mothers who were positive for COVID-19.
birth weight, and there were reported to be 71 neonates who
were positive for covid 19. Most types of delivery were cesarean
sections. It was reported that there were 18 cases of maternal
death with positive covid 19, and it was reported that there were
5 neonatal deaths, 4 of which were positive for covid. The result
of characteristics and maternal signs, symptoms, and impact of
COVID-19 on maternal and neonatal can be seen in Table 2
Based on the results of a review of 8 articles, it was found
that covid 19 infection in pregnant women can cause
morbidity. On the fifth day after the commencement of the
condition, the patient had respiratory failure and required
mechanical ventilation. (Alzamora et al. 2020) Several
studies report maternal deaths due to COVID-19 infection.
(Al-Matary et al. 2021; Nayak et al. 2021; Sohaib et al. 2022;
Villar et al. 2021) There were 16 cases of maternal death due
to covid 19 infections reported in 4 studies; in the group of
women with COVID-19 diagnosis, the probability of maternal
mortality was 1.6 percent or 22 times greater. COVID-19 in
pregnancy can be deadly when comprehensive ICU services
are not fully available since these deaths were clustered in
institutions from less developed regions.Except for
preeclampsia, we discovered that asymptomatic women
with COVID-19 diagnosis had similar outcomes to women
without COVID-19 diagnosis. (Villar et al. 2021) Most
pregnant women testing positive for SARS-CoV-2 were
asymptomatic, and none transmitted the virus to their
babies. (Zlochiver et al. 2021) Another study also showed
that 9 of pregnant women with severe COVID-19 infection, 7
of 9 died, 1 of 9 needed a ventilator and 1 again required a
long hospital stay, most of which occurred in the 2nd and
3rd trimesters of pregnancy. (Hantoushzadeh et al. 2020).
In this study, the most common COVID-19 symptoms
among pregnant women were cough, fever, and short breath.
In a case series study conducted by Shahla Chaichan, et all,
the most common symptoms were myalgia and fatigue.
However, in most studies, cough, and fever were the most
common symptoms. (Chaichian et al. 2021) In this study, the
most common type of delivery is by cesarean section. In
patients with COVID-19, vaginal delivery is not
recommended because there is no strong evidence of vertical
transmission; when a dangerously unwell parturient

Pregnancy and Covid 19 Infection: Characteristics, Signs, Symptoms, and Impact on Maternal and Neonatal: Systematic Review
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7 (S1), 2022,– 258
Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

Table 2
Study Characteristics and Maternal Signs, Symptoms, and Impact of COVID-19 on Maternal and Neonatal

Author
M. Abedzadeh-
C,
Nayak,et al. A. Almatary,et Kalahroudi ,et M S, Asghar,
Daclin,et al. Arinkan,et al. Ferrugini,et J. Villar, et al.
(2021) al. (2021) (Al- al. (2021) et. al (2022)
Variable (2022) (Daclin (2021) (Arinkan al. (2021) (2021) (Villar et
(Nayak et al. Matary et al. (Abedzadeh- (Sohaib et al.
et al. 2022) et al. 2021) (Ferrugini et al. 2021)
2021) 2021) Kalahroudi et al. 2022)
al. 2022)
2021)
Methods Prospective Retrospective Case-control prospective
case series Crossectional Multinational Retrospective
Observational Descriptive retrospective observational
study study cohort study Cohort Study
Study Study study study
Pregnant women 162 288 26 172 116 265 2130 131
Positive Covid 19 162 288 26 86 (Case) 46 (Case) 86 706 60
Negative Covid 19 0 0 0 86 70 (Control) 179 1424 -
Non-Pregnant Women Positif Covid 19 (Control) 71
Neonatal 165 (5 twins) 204 26 86 116 8 2130
Location COVID Hospital in University Foch Hospital, Umraniye HUCAM 43 institutions in Liaquat
hospital, Riyadh City in hospital of West Parisian Research and maternity 18 countries National
Odisha state Saudi Arabia Kashan Iran area Training hospital (Argentina, Brazil, Hospital,
(India) Hospital Victoria, Egypt, France, Pakistan
capital, Brazil Ghana, India,
Indonesia, Italy,
Japan, Mexico,
Nigeria, North
Macedonia,
Pakistan, Russia,
Spain,
Switzerland, the
UK, and the US).
Mean Age Maternal 31 (19-41) 30,0 (35-26) 30,6 (37,1-24,1) 32,1(37,1-27,1) 28s,87(±4,74) <19 y old : 30,2 (±6,1) 28.11(± 5.24)
13(15,1)
20-34 y old :
57 (66,3)
≥35 y old : 16
(18,6)
Mean Gestational Age 37,5 (25-41) 38 (39-33) 31,8 (37-26,6) 39,29 (2,65) 37,02(5,85) ≤13 weeks : 3 37,9 (±3,3) 31,46 (±6,13)
(3,5)
14 w – 27 w :
2 (2,3)
28 w-36 w :
20 (23,3)
≥37 w :
61(70,9)
Symptoms

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Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari
Author
M. Abedzadeh-
C,
Nayak,et al. A. Almatary,et Kalahroudi ,et M S, Asghar,
Daclin,et al. Arinkan,et al. Ferrugini,et J. Villar, et al.
(2021) al. (2021) (Al- al. (2021) et. al (2022)
Variable (2022) (Daclin (2021) (Arinkan al. (2021) (2021) (Villar et
(Nayak et al. Matary et al. (Abedzadeh- (Sohaib et al.
et al. 2022) et al. 2021) (Ferrugini et al. 2021)
2021) 2021) Kalahroudi et al. 2022)
al. 2022)
2021)
1. Fever - 44 25 24 - 25 199 37 (61.7%)
2. Cough - 92 8 30 41,3% 28 48 41 (68.3%)
3. Diary - 8 2 - 2,2% 8 - 19 (31.7%)
4. Dyspnea/Shortness of breath 21 36 8 5 - 16 89 40 (66.7%)
5. Sore throat
6. Fatigue - 33 - - - 10 - -
7. Myalgia - 17 - - 2,2% - - 47 (78.3%)
8. Malaise - 2 - - 15,2% 25 - -
9. Nausea or vomiting - 8 - - - - - -
10. Asymptomatic - 7 - - - - - -
11. Headache - 41 - 22 - 30 288 -
- - 4 0 - 26 - -
Maternal Complication / Impact of
pregnancy
1. Hemorrhage 2 - - 4 - - 44 -
2. PROM 25 16 1 - - - 114 -
3. Preeclampsia - 4 6 1 - 19 59 5
4. Fetal distress 27 13 2 - - - 87 -
5. Preterm labor - 31 11 - 6 21 159 4
6. Miscarriage - - - - - 6 - -
Neonatal Complication
1. Low Birth Weight 49 29 9 0 - 11 145 -
2. Preterm 27 31 11 - - 21 159 4
3. Positive Covid 19 9 0 8 - 1 3 54 -
4. RDS 8 - - - - 3 - -
Delivered
Yes 162 204 26 46 82 706 57
86
No - 84 - - 4 0 3
Mode of delivery
1. Vaginal 59 131 8 51 - 25 360 15
2. Section Cesarea 103 73 18 33 - 57 346 42
Maternal Mortality 1 1 - - 2 - 11 3
Neonatal Mortality 5 0 0 - - 2 - -
Stillbirth/ IUFD 2 4 0 - - - - 2

Pregnancy and Covid 19 Infection: Characteristics, Signs, Symptoms, and Impact on Maternal and Neonatal: Systematic Review
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Yuni Purwatiningsih; Sinta Dewi Lestyoningrum; Aliesya Patricia Wulandari

LIMITATION OF THE STUDY Chaichian, Shahla et al. 2021. “Maternal and Fetal Outcomes of
Pregnant Women Infected with Coronavirus Based on
The limitation of this study is not registered in the Tracking the Results of 90-Days Data in Hazrat -E- Rasoul
International Prospective Register of Systematic Reviews Akram Hospital, Iran University of Medical Sciences.”
(PROSPERO). Our literature search used three databases only, Bulletin of emergency and trauma 9(3): 145–50.
and our literature search was restricted to publications in Daclin, Camille et al. 2022. “Impact of COVID-19 Infection in
English. We did not conduct the meta-analysis, we review Pregnancy and Neonates: A Case Control Study.” Journal of
and used the narrative method. Gynecology Obstetrics and Human Reproduction 51: 102366.
Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, Choolani
CONCLUSIONS AND SUGGESTIONS M, Mattar C, Su LL. 2020. “Special Report and Pregnancy.”
Am J Obstet Gynecol 222(6): 521–31.
Pregnant women generally have the same symptoms as Ferrugini, Carolina Loyola Prest et al. 2022. “SARS-CoV-2
those who are not pregnant. For pregnant women who are Infection in Pregnant Women Assisted in a High-Risk
positive for Covid 19, fever, cough, and shortness of breath Maternity Hospital in Brazil: Clinical Aspects and Obstetric
often appear. The most complications that arise from Outcomes.” Plos One 17(3): e0264901.
mothers who are positive for COVID-19 are PROM and http://dx.doi.org/10.1371/journal.pone.0264901.
premature birth. The incidence of maternal deaths that were
positive for COVID-19 was recorded in several studies. Strict Gandhi, Rajesh T., John B. Lynch, and Carlos del Rio. 2020. “Mild
or Moderate Covid-19.” New England Journal of Medicine
supervision for pregnant women who are positive for Covid
383(18): 1757–66.
19 is necessary to avoid seriousness.
Hantoushzadeh, Sedigheh et al. 2020. “Maternal Death Due to
Acknowledgment COVID-19.” American Journal of Obstetrics and Gynecology
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https://doi.org/10.1016/j.ajog.2020.04.030.
ETHICAL CONSIDERATIONS
Harrison, Andrew G., Tao Lin, and Penghua Wang. 2020.
“Mechanisms of SARS-CoV-2 Transmission and
We did not seek ethical considerations for this systematic
Pathogenesis.” Trends in Immunology 41(12): 1100–1115.
review because the data were publicly available.
https://doi.org/10.1016/j.it.2020.10.004.

Funding Statement Jamieson, Denise J., and Sonja A. Rasmussen. 2021. “An Update
on COVID-19 and Pregnancy.” American Journal of Obstetrics
The authors did not receive support from any and Gynecology. https://doi.org/10.1016/j.ajog.2021.08.054.
organization for the submitted work.
Nayak, Manas Kumar et al. 2021. “Neonatal Outcomes of
Pregnant Women with COVID-19 in a Developing Country
Conflict of Interest Statement Setup.” Pediatrics and Neonatology 62(5): 499–505.

No potential conflicts of interest were reported by the Schwartz, David A., and Ashley L. Graham. 2020. “Potential
authors. The author is solely responsible for the views Maternal and Infant Outcomes from Coronavirus 2019-NCOV
expressed in this publication. (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS,
MERS, and Other Human Coronavirus Infections.” Viruses
12(2): 1–16.

Smith, Vinayak et al. 2020. “Maternal and Neonatal Outcomes

Associated with COVID-19 Infection: A Systematic Review.”
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Pregnancy and Covid 19 Infection: Characteristics, Signs, Symptoms, and Impact on Maternal and Neonatal: Systematic Review