Safety of hospital birth during the covid-19 lockdown period: systematic review with meta-analysis

Objective: To synthesize evidence on the safety of hospital delivery for asymptomatic pregnant women regarding the risk of SARS-CoV infection during the COVID-19 lockdown period. Method: systematic review with meta-analysis of articles published in PubMed, CINAHL, Embase and Web of Science databases. The risk of bias of the included studies was assessed according to the epidemiological design and heterogeneity was explored using the Egger test. Results: These 23 studies included 650 pregnant women with a mean age of 26.9 (±5.9) years. The pooled prevalence of SARS-Cov-positive pregnant women by RT-PCR and nasopharyngeal swab at admission was 74.3% (95%CI 0.65 – 0.83; I2=48.3). On the other hand, the prevalence of positive pregnant women after childbirth was 3.6% (95%CI 0.00 – 0.06; I2=89.8). There was a higher proportion of births that took place in a hospital environment (73.5%) compared to births in an extra-hospital environment (26.4%). The combined proportions of newborns tested after birth were 58.2% (95%CI 0.63 – 0.89;I2=36.9) and of preterm births (<37 weeks) of 14.5% (95%CI 0 .13 - 0.33; I2=88.9). Conclusions: hospital delivery proved to be safe for asymptomatic pregnant women regarding the risk of infection during the COVID-19 lockdown period.