Comparison of the pregnant and non-pregnant women of reproductive age hospitalized due to COVID-19 infection.
Yıl 2022,
Cilt: 39 Sayı: 4, 1194 - 1201, 29.10.2022
Özgür Kılıç
,
Mehmet Polat
,
Tibel Tuna
,
Eda Kopru
,
M Elmali
,
İlkay Bozkurt
,
Davut Güven
,
Melda Dilek
Öz
COVID-19 affects pregnant women more severely than nonpregnant women of reproductive age. However, the rate of critical illness and fatality reported from other studies varied in a wide range in both groups. The study aims to investigate the clinical outcomes of COVID-19 in the pregnant and nonpregnant matched control patients admitted to the hospital. Pregnant and non-pregnant patients of reproductive age (18-45 years) infected with COVID-19 who were admitted to Ondokuz Mayıs University Hospital, Samsun, Turkey, from March 11 to December 11, 2020, were enrolled in the study. The clinical, radiological, and laboratory data of the patients were analyzed retrospectively. A total of 153 patients were investigated; 123 were nonpregnant and 30 were pregnant. Emergency delivery occurred in 5 (17%) pregnant women due to acute respiratory failure associated with COVID-19, and in 1 (3%) pregnant due to obstetric reasons. Four premature births, one perinatal death, and no stillbirth or miscarriage were reported. The rate of admission to the intensive care unit (ICU) [7/30 (23.3%) vs 3/123 (2.4%), p<0.001] and the need for invasive mechanical ventilation (IMV) [5/30 (17.0%) vs 2/123 (1.6%), p=0.003] were significantly higher in pregnant than in non-pregnant patients. However, hospital length of stay (HLOS) and mortality did not differ between groups: HLOS was median 4 vs 5 days; p=0.68, and mortality rate was 1/123 (0.8%) vs 0/30 (0%), p=0.62 in non-pregnant and pregnant patients respectively. We observed that COVID-19 has a more severe course in pregnant women versus the nonpregnant control group, but no difference was noted in terms of hospital length of stay and mortality. Overall case fatality rate of COVID-19 in either hospitalized pregnant or nonpregnant women of reproductive age was found to be much lower than the general hospitalized population worldwide.
Kaynakça
- Referans1 Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, et al. Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2021 Apr 1;137(4):571-580.
- Referans2 Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K, et al. Pregnancy and neonatal outcomes of COVID-19: reporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol. 2021 Apr;57(4):573-581.
- Refernas3 Huntley BJF, Mulder IA, Di Mascio D, Vintzileos WS, Vintzileos AM, Berghella V, et al. Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-analysis. Obstet Gynecol. 2021 Apr 1;137(4):585-596.
- Referans4 Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, et al. Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic. JAMA Netw Open. 2021 Aug 2;4(8):e2120456.
- Referans5 Kasehagen L, Byers P, Taylor K, Kittle T, Roberts C, Collier C, et al. COVID-19-Associated Deaths After SARS-CoV-2 Infection During Pregnancy - Mississippi, March 1, 2020-October 6, 2021. MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1646-1648.
- Referans6 Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020 Sep 1;370:m3320.
- Referans7 Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020 Nov 6;69(44):1641-1647.
- Referans8 Badr DA, Mattern J, Carlin A, Cordier AG, Maillart E, El Hachem L, et al. Are clinical outcomes worse for pregnant women at ≥20 weeks' gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol. 2020 Nov;223(5):764-768.
- Referann9 Qeadan F, Mensah NA, Tingey B, Stanford JB. The risk of clinical complications and death among pregnant women with COVID-19 in the Cerner COVID-19 cohort: a retrospective analysis. BMC Pregnancy Childbirth. 2021 Apr 16;21(1):305.
- Referans10 DeBolt CA, Bianco A, Limaye MA, Silverstein J, Penfield CA, Roman AS, et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2021 May;224(5):510.e1-510.e12.
- Referans11 Lokken EM, Huebner EM, Taylor GG, Hendrickson S, Vanderhoeven J, Kachikis A, et al. Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infections in Washington State. Am J Obstet Gynecol. 2021 Jul;225(1):77.e1-77.e14.
- Referans12 Dawood FS, Varner M, Tita A, Newes-Adeyi G, Gyamfi-Bannerman C, Battarbee A, et al. Incidence, Clinical Characteristics, and Risk Factors of SARS-CoV-2 Infection among Pregnant Individuals in the United States. Clin Infect Dis. 2021 Aug 19:ciab713.
- Referans13 Gulersen M, Rochelson B, Shan W, Wetcher CS, Nimaroff M, Blitz MJ. Severe maternal morbidity in pregnant patients with SARS-CoV-2 infection. Am J Obstet Gynecol MFM. 2022 Jul;4(4):100636.
- Referans14 McClymont E, Albert AY, Alton GD, Boucoiran I, Castillo E, Fell DB, et al. Association of SARS-CoV-2 Infection During Pregnancy With Maternal and Perinatal Outcomes. JAMA. 2022 May 24;327(20):1983-1991.
- Referans15 Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020 Mar 7;395(10226):809-815.
- Referans16 Tamanna S, Clifton VL, Rae K, van Helden DF, Lumbers ER, Pringle KG. Angiotensin Converting Enzyme 2 (ACE2) in Pregnancy: Preeclampsia and Small for Gestational Age. Front Physiol. 2020 Sep 30;11:590787.
- Referans17 Narang K, Enninga EAL, Gunaratne MDSK, Ibirogba ER, Trad ATA, Elrefaei A, et al. SARS-CoV-2 Infection and COVID-19 During Pregnancy: A Multidisciplinary Review. Mayo Clin Proc. 2020 Aug;95(8):1750-1765.
- Referans18 Pineles BL, Goodman KE, Pineles L, O'Hara LM, Nadimpalli G, Magder LS, et al. In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19. Ann Intern Med. 2021 Aug;174(8):1186-1188.
- Referans19 Leung C, de Paiva KM. Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study. Int J Gynaecol Obstet. 2022 Apr;157(1):121-129.
- Referans20 Hsu AL, Ohler AM, Goldstein A, Truong S, Tang CY, Wan XF et al. Coronavirus Disease 2019 (COVID-19) Disease Severity: Pregnant vs Nonpregnant Women at 82 Facilities. Clin Infect Dis. 2022 Feb 11;74(3):467-471.
- Referans21 National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available from: https://www.covid19treatmentguidelines.nih.gov/
- Referans22 Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.
- Referans23 Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-721.
- Referans24 Tabatabaei SMH, Rajebi H, Moghaddas F, Ghasemiadl M, Talari H. Chest CT in COVID-19 pneumonia: what are the findings in mid-term follow-up? Emerg Radiol. 2020;27(6):711-719.
- Referans25 Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K et al. Pregnancy and neonatal outcomes of COVID-19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol. 2021 Apr;57(4):573-581.
- Referans26 Huntley BJF, Mulder IA, Di Mascio D, Vintzileos WS, Vintzileos AM, Berghella V et al. Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-analysis. Obstet Gynecol. 2021 Apr 1;137(4):585-596.
- Referans27 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):292-297.
- Referans28 Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775.
- Referans29 Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020;2(2):100107.
- Referans30 Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis . AJR Am J Roentgenol. 2020;215(1):127-132.
- Referans31 Martinez-Portilla RJ, Sotiriadis A, Chatzakis C, Torres-Torres J, Espino Y Sosa S, Sandoval-Mandujano K, et al.Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound Obstet Gynecol. 2021 Feb;57(2):224-231.
- Referans32 Society for Maternal-Fetal Medicine. Management considerations for pregnant patients with COVID-19. Available from: https://s3.amazonaws.com/cdn.smfm.org/media/2334/SMFM_COVID_Management_of_COVID_pos_preg_patients_4-29-20_final.pdf.
- Referans33 Centre for Evidence-Based Medicine. Global COVID-19 Case Fatality Rates. Available from: https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/
- Referans34 International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC). Available from: https://media.tghn.org/medialibrary/2020/05/ISARIC_Data_Platform_COVID- 19_Report_19MAY20.pdf.
- Referans35 Karimi L, Makvandi S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis. J Pregnancy. 2021;2021:8870129. Published 2021 Mar 5.
- Referans36 Galang RR, Newton SM, Woodworth KR, Griffin I, Oduyebo T, Sancken CL et al. Risk Factors for Illness Severity Among Pregnant Women With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 Infection-Surveillance for Emerging Threats to Mothers and Babies Network, 22 State, Local, and Territorial Health Departments, 29 March 2020-5 March 2021. Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S17-S23.
- Referans37 Wastnedge EAN, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiol Rev. 2020;1;101(1):303-318.
- Referans38 Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One. 2020;15(11):e0241955.
- Referans39 Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM. 2020;2(3):100134.
- Referans40 Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526-2533.
Yıl 2022,
Cilt: 39 Sayı: 4, 1194 - 1201, 29.10.2022
Özgür Kılıç
,
Mehmet Polat
,
Tibel Tuna
,
Eda Kopru
,
M Elmali
,
İlkay Bozkurt
,
Davut Güven
,
Melda Dilek
Kaynakça
- Referans1 Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, et al. Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2021 Apr 1;137(4):571-580.
- Referans2 Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K, et al. Pregnancy and neonatal outcomes of COVID-19: reporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol. 2021 Apr;57(4):573-581.
- Refernas3 Huntley BJF, Mulder IA, Di Mascio D, Vintzileos WS, Vintzileos AM, Berghella V, et al. Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-analysis. Obstet Gynecol. 2021 Apr 1;137(4):585-596.
- Referans4 Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, et al. Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic. JAMA Netw Open. 2021 Aug 2;4(8):e2120456.
- Referans5 Kasehagen L, Byers P, Taylor K, Kittle T, Roberts C, Collier C, et al. COVID-19-Associated Deaths After SARS-CoV-2 Infection During Pregnancy - Mississippi, March 1, 2020-October 6, 2021. MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1646-1648.
- Referans6 Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020 Sep 1;370:m3320.
- Referans7 Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020 Nov 6;69(44):1641-1647.
- Referans8 Badr DA, Mattern J, Carlin A, Cordier AG, Maillart E, El Hachem L, et al. Are clinical outcomes worse for pregnant women at ≥20 weeks' gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol. 2020 Nov;223(5):764-768.
- Referann9 Qeadan F, Mensah NA, Tingey B, Stanford JB. The risk of clinical complications and death among pregnant women with COVID-19 in the Cerner COVID-19 cohort: a retrospective analysis. BMC Pregnancy Childbirth. 2021 Apr 16;21(1):305.
- Referans10 DeBolt CA, Bianco A, Limaye MA, Silverstein J, Penfield CA, Roman AS, et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2021 May;224(5):510.e1-510.e12.
- Referans11 Lokken EM, Huebner EM, Taylor GG, Hendrickson S, Vanderhoeven J, Kachikis A, et al. Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infections in Washington State. Am J Obstet Gynecol. 2021 Jul;225(1):77.e1-77.e14.
- Referans12 Dawood FS, Varner M, Tita A, Newes-Adeyi G, Gyamfi-Bannerman C, Battarbee A, et al. Incidence, Clinical Characteristics, and Risk Factors of SARS-CoV-2 Infection among Pregnant Individuals in the United States. Clin Infect Dis. 2021 Aug 19:ciab713.
- Referans13 Gulersen M, Rochelson B, Shan W, Wetcher CS, Nimaroff M, Blitz MJ. Severe maternal morbidity in pregnant patients with SARS-CoV-2 infection. Am J Obstet Gynecol MFM. 2022 Jul;4(4):100636.
- Referans14 McClymont E, Albert AY, Alton GD, Boucoiran I, Castillo E, Fell DB, et al. Association of SARS-CoV-2 Infection During Pregnancy With Maternal and Perinatal Outcomes. JAMA. 2022 May 24;327(20):1983-1991.
- Referans15 Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020 Mar 7;395(10226):809-815.
- Referans16 Tamanna S, Clifton VL, Rae K, van Helden DF, Lumbers ER, Pringle KG. Angiotensin Converting Enzyme 2 (ACE2) in Pregnancy: Preeclampsia and Small for Gestational Age. Front Physiol. 2020 Sep 30;11:590787.
- Referans17 Narang K, Enninga EAL, Gunaratne MDSK, Ibirogba ER, Trad ATA, Elrefaei A, et al. SARS-CoV-2 Infection and COVID-19 During Pregnancy: A Multidisciplinary Review. Mayo Clin Proc. 2020 Aug;95(8):1750-1765.
- Referans18 Pineles BL, Goodman KE, Pineles L, O'Hara LM, Nadimpalli G, Magder LS, et al. In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19. Ann Intern Med. 2021 Aug;174(8):1186-1188.
- Referans19 Leung C, de Paiva KM. Is pregnancy a risk factor for in-hospital mortality in reproductive-aged women with SARS-CoV-2 infection? A nationwide retrospective observational cohort study. Int J Gynaecol Obstet. 2022 Apr;157(1):121-129.
- Referans20 Hsu AL, Ohler AM, Goldstein A, Truong S, Tang CY, Wan XF et al. Coronavirus Disease 2019 (COVID-19) Disease Severity: Pregnant vs Nonpregnant Women at 82 Facilities. Clin Infect Dis. 2022 Feb 11;74(3):467-471.
- Referans21 National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available from: https://www.covid19treatmentguidelines.nih.gov/
- Referans22 Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.
- Referans23 Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-721.
- Referans24 Tabatabaei SMH, Rajebi H, Moghaddas F, Ghasemiadl M, Talari H. Chest CT in COVID-19 pneumonia: what are the findings in mid-term follow-up? Emerg Radiol. 2020;27(6):711-719.
- Referans25 Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K et al. Pregnancy and neonatal outcomes of COVID-19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol. 2021 Apr;57(4):573-581.
- Referans26 Huntley BJF, Mulder IA, Di Mascio D, Vintzileos WS, Vintzileos AM, Berghella V et al. Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-analysis. Obstet Gynecol. 2021 Apr 1;137(4):585-596.
- Referans27 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):292-297.
- Referans28 Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775.
- Referans29 Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020;2(2):100107.
- Referans30 Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis . AJR Am J Roentgenol. 2020;215(1):127-132.
- Referans31 Martinez-Portilla RJ, Sotiriadis A, Chatzakis C, Torres-Torres J, Espino Y Sosa S, Sandoval-Mandujano K, et al.Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound Obstet Gynecol. 2021 Feb;57(2):224-231.
- Referans32 Society for Maternal-Fetal Medicine. Management considerations for pregnant patients with COVID-19. Available from: https://s3.amazonaws.com/cdn.smfm.org/media/2334/SMFM_COVID_Management_of_COVID_pos_preg_patients_4-29-20_final.pdf.
- Referans33 Centre for Evidence-Based Medicine. Global COVID-19 Case Fatality Rates. Available from: https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/
- Referans34 International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC). Available from: https://media.tghn.org/medialibrary/2020/05/ISARIC_Data_Platform_COVID- 19_Report_19MAY20.pdf.
- Referans35 Karimi L, Makvandi S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis. J Pregnancy. 2021;2021:8870129. Published 2021 Mar 5.
- Referans36 Galang RR, Newton SM, Woodworth KR, Griffin I, Oduyebo T, Sancken CL et al. Risk Factors for Illness Severity Among Pregnant Women With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 Infection-Surveillance for Emerging Threats to Mothers and Babies Network, 22 State, Local, and Territorial Health Departments, 29 March 2020-5 March 2021. Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S17-S23.
- Referans37 Wastnedge EAN, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiol Rev. 2020;1;101(1):303-318.
- Referans38 Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One. 2020;15(11):e0241955.
- Referans39 Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM. 2020;2(3):100134.
- Referans40 Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526-2533.