Evidence map›Paper›PMID 36368768›Full record

SynthesisBMJ global health2022

Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country's income status: a meta-analysis.

Jameela Sheikh, Heidi Lawson, John Allotey, Magnus Yap, Rishab Balaji, Tania Kew, Elena Stallings, Dyuti Coomar, Andrea Gaetano-Gil, Javier Zamora and 2 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jameela SheikhCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.ORCID 0000-0002-6409-6940
Heidi LawsonCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.ORCID 0000-0002-9706-7193
John AlloteyInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.ORCID 0000-0003-4134-6246
Magnus YapCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Rishab BalajiCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Tania KewCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.ORCID 0000-0001-9363-3760
Elena StallingsClinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.ORCID 0000-0002-3386-3406
Dyuti CoomarInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.ORCID 0000-0001-6229-0830
Andrea Gaetano-GilClinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.ORCID 0000-0001-5725-531X
Javier ZamoraInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.ORCID 0000-0003-4901-588X
Shakila ThangaratinamInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK s.thangaratinam.1@bham.ac.uk.ORCID 0000-0002-4254-460X
PregCOV-19 Living Systematic Review Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe prevalence of COVID-19 and its impact varied between countries and regions. Pregnant women are at high risk of COVID-19 complications compared with non-pregnant women. The magnitude of variations, if any, in SARS-CoV-2 infection rates and its health outcomes among pregnant women by geographical regions and country's income level is not known.

methodsWe performed a random-effects meta-analysis as part of the ongoing PregCOV-19 living systematic review (December 2019 to April 2021). We included cohort studies on pregnant women with COVID-19 reporting maternal (mortality, intensive care admission and preterm birth) and offspring (mortality, stillbirth, neonatal intensive care admission) outcomes and grouped them by World Bank geographical region and income level. We reported results as proportions with 95% confidence intervals (CI).

resultsWe included 311 studies (2 003 724 pregnant women, 57 countries). The rates of SARS-CoV-2 infection in pregnant women varied significantly by region (p<0.001) and income level (p<0.001), with the highest rates observed in Latin America and the Caribbean (19%, 95% CI 12% to 27%; 13 studies, 38 748 women) and lower-middle-income countries (13%, 95% CI 6% to 23%; 25 studies, 100 080 women). We found significant differences in maternal and offspring outcomes by region and income level. Lower-middle-income countries reported significantly higher rates of maternal mortality (0.68%, 95% CI 0.24% to 1.27%; 3 studies, 31 136 women), intensive care admission (4.53%, 95% CI 2.57% to 6.91%; 54 studies, 23 420 women) and stillbirths (1.09%, 95% CI 0.48% to 1.88%; 41 studies, 4724 women) than high-income countries. COVID-19 complications disproportionately affected South Asia, which had the highest maternal mortality rate (0.88%, 95% CI 0.16% to 1.95%; 17 studies, 2023 women); Latin America and the Caribbean had the highest stillbirth rates (1.97%, 95% CI 0.9% to 3.33%; 10 studies, 1750 women).

conclusionThe rates of SARS-CoV-2 infection in pregnant women vary globally, and its health outcomes mirror the COVID-19 burden and global maternal and offspring inequalities. PROSPERO REGISTRATION NUMBER: CRD42020178076.

Indexed as

COVID-19Premature BirthFemaleHumansInfant, NewbornMaternal MortalityPregnancySARS-CoV-2StillbirthCOVID-19Maternal health

Identifiers

PMID36368768
PMCPMC9659713

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.