Background
Methods
Criteria for potentially eligible studies
Search strategy
Selection of studies
Data extraction and data entry
Data analysis
Results
Location | Source (Study number as per ripe-tomato.org or database) | Pregnant women with confirmed COVID-19 infection with outcomes reported | Women who required critical care. N/A not available | Women who delivered, presumed healthy1 | Women with ongoing pregnancies, presumed healthy1 | Venous thrombotic events | Arterial thrombotic events | Disseminated intravascular coagulation (DIC) events |
---|---|---|---|---|---|---|---|---|
China | ||||||||
Zhongnan Hospital of Wuhan University | 1 | 9 | 0 | 9 | 0 | 0 | 0 | 0 |
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology | 2a | 3 | 0 | 3 | 0 | 0 | 0 | 0 |
The first Affiliated Hospital, College of Medicine, Zhejiang University | 4 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology | 6 | 15 | 0 | 11 | 4 | 0 | 0 | 0 |
Qingdao Women and Children’s Hospital, Qingdao | 7 | 1 | 0 | 0 | 1 | 0 | 0 | 0 |
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | 15 | 7 | 0 | 7 | 0 | 0 | 0 | 0 |
Affiliated Infectious Hospital of Soochow University, Suzhou | 19 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
Maternal and Child Hospital of Hubei Province | 30 | 34 | 0 | 34 | 0 | 0 | 0 | 0 |
Beijing YouAn Hospital, Capital Medical University | 34 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Renmin Hospital of Wuhan University | 36 | 173a | N/A | 14 | 0 | 0 | 0 | 0 |
Renmin Hospital of Wuhan University | 37 | 3 | 0 | 3 | 0 | 0 | 0 | 0 |
No 2 People’s Hospital of Hefei City Affiliated to Anhui Medical University | 62 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Central Hospital of Wuhan | 73 | 284e | N/A | 22 | 2 | 0 | 0 | 0 |
Xiaolan People’s Hospital of Zhongshan, Guandong | 81 | 1 | 1 | 1 | 0 | 0 | 0 | 1 |
USA | ||||||||
MedStar Washington Hospital Center, DC | 21 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Newark Beth Israel Medical Centre, New Jersey | 28 | 2a,b | N/A | 0 | 0 | 0 | 0 | 0 |
Saint Barnabas Medical Center, Livingston, New Jersey | 111 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
Morristown medical centre, St Peter’s University Medical Centre, New Jersey | 159 | 3 | 3 | 0 | 3 | 0* | 0 | 0 |
“Network’s 2 largest hospitals” in New Jersey: Likely Hackensack University Medical Centre, Rutgers New Jersey Medical School Newark, Seton Hall University Nutley, Jersey Shore University Medical Centre, Neptune, | 149 | 8 | 8 | 7 | 1 | 0 | 0 | 0 |
Good Samaritan Hospital, Cincinnati, Ohio | 50 | 1b | 1 | 0 | 0 | 0 | 0 | 0** |
Lexington Medical Centre, West Columbia, South Carolina | 60 | 1 | 0 | 0 | 1 | 0 | 0 | 0 |
Hospital of the University of Pennsylvania | 65 | 5b | 5 | 3 | 1 | 1 | 0 | 0 |
Washington University in St Louis, Missouri | 69 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
Beaumont Hospital Dearborn, Dearborn, Michigan | 123 | 16 | 0 | 10 | 6 | 0 | 0 | 0 |
Henry Ford Hospital Department of Obstetrics and Gynecology, Detroit, Michigan (distinct case from 123) | 87 | 1 | 1 | 0 | 1 | 0 | 0* | 0 |
University of California, San Francisco, California | 89 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
Stanford University Hospital, California | 115 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
New York University, Winthrop hospital, Langone health | 91 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
New York University, Langone Health (distinct case) | 98 | 1c | 0 | 0 | 0 | 0 | 0 | 0 |
Weil Cornell Medicine, New York** | 99 | 20h | 0 | 19 | 0 | 0 | 0 | 0 |
Norwell Group, New York | 118 162 | 132g,a | 13 | 5 | 5 | 0 | 0 | 0** |
New York University, Langone health | 152 | 2 | 2 | 2 | 0 | 0 | 0 | 0 |
Six hospital systems in Washington state | 102 | 46 | 1 | 8 | 38 | 0 | 0 | 0 |
University of Tennessee Health Science Center, Nashville, United States | 112 | 1 | 1 | 0 | 1 | 0 | 0 | 0 |
Yale School of Medicine | 155 | 1e | N/A | 0 | 0 | 0 | 0 | 1 |
Advocate Good Samaritan Hospital, Illinois, United States^ | COV-PREG-COAG | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
St Joseph Hospital, Denver | 156 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Canada | ||||||||
Mount Sinai Hospital, Toronto | 48 | 1 | 0 | 1 | 0 | 0 | 0 | 1 |
Honduras | ||||||||
Hospital Escuela de Tegucigalpa | 18 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Sweden | ||||||||
Southern General Hospital, Stockholm | 20 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
France | ||||||||
Antoine Beclere Hospital, Clamart | 48 | 1 | N/A | 1 | 0 | 0 | 0 | 1 |
Hospitaux Universitaires de Strasbourg | 161 | 54a,b,d | 5 | 20 | 31 | 0 | 0 | 0 |
Canary Islands | ||||||||
Hospitalario Universitario Insular Materno Infantil, Gran Canaria | 53 | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
Italy | ||||||||
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy | 76 | 7c | N/A | 4 | 2 | 0 | 0 | 0 |
12 Italian hospitals (non-overlapping with others in table) | 117 | 26 | 14 | 6 | 20 | 0 | 0 | 0 |
Parma Hospital, Italy | 109 | 4 | N/A | 4 | 0 | 0 | 0 | 0 |
6 hospitals of Azienda USL 62 “Toscana Nord Ovest” [ATNO] (Tuscany), and Gaslini Children’s Hospital (Genoa, Liguria) | 133 | 3 | 0 | 3 | 0 | 0 | 0 | 0 |
UK | ||||||||
Portland Hospital London | 82 | 8 | 0 | 8 | 0 | 0 | 0 | 0 |
East Midlands Research group (University Hospitals of Leicester and Nottingham University Hospitals) | East Midlands Research Group | 30b,g | 2 | 21 | 7 | 0 | 0 | 1 |
UK (Nationwide)- UKOSS database with case information as per paper 107. | UKOSS + 107 | 4275g | 41 | 261 | 161 | 1 | 1 | 0 |
Belgium | ||||||||
Cliniques Universitaires, St Luc, Brussels, | 100 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
4 Obstetric units in North East Flanders | 128 | 13 | 0 | 13 | 0 | 0 | 0 | 0 |
Portugal | ||||||||
Hospital Pedro Hispano | 105 | 12 | 0 | 10 | 2 | 0 | 0 | 0 |
Porto (distinct case) | 94 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Portugal (distinct case) | 74 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Netherlands | ||||||||
Netherlands COVID-19 registry | 141 | 176d,g,i | 7 | 49 | 124 | 1g | 0 | 0 |
Germany | ||||||||
Ulm university | 127 | 2 | 0 | 2 | 0 | 0 | 0 | 0 |
Spain | ||||||||
Jaen | 158 | 4 | 0 | 0 | 4 | 0 | 0 | 0 |
Barcelona | 140 | 8 | 8 | 4 | 4 | 0 | 0 | 0 |
South Korea | ||||||||
Daegu Fatimal Hospital | 22 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Japan | ||||||||
Keio University Hospital, Tokyo | 144 | 2 | 0 | 0 | 2 | 0 | 0 | 0 |
Turkey | ||||||||
Ankara University Faculty of Medicine, | 31 | 1b | 1 | 0 | 0 | 0 | 0 | 0 |
Sehit Prof Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul | 146 | 8c | 1 | 2 | 5 | 0 | 0 | 0 |
Necmettin Erkbakan University, Konya | 145 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Jordan | ||||||||
Jordan | 153 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Australia | ||||||||
Gold Coast University Hospital | 45 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
India | ||||||||
Designated Covid Hospital | 58 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Iran | ||||||||
Tehran/Rasht/Qom/Zanjan | 67 | 97g,b | 9 | 1 | 0 | 0 | 0 | 1** |
Imam Khomeini Hospital, Sari, Iran | 70 | 1g | 1 | 0 | 0 | 0 | 0 | 0 |
Imam Reza Hospital of Tabriz, Iran | 101 | 1b | 1 | 0 | 0 | 0 | 0 | 1 |
Thailand | ||||||||
Thailand (reported by ministry of public health) | 110 | 1f | 0 | 0 | 0 | 0 | 0 | 0 |
Russia | ||||||||
Russian Federation, Private Center^ | COV-PREG-COAG | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
UAE | ||||||||
Al Ain Hospital, United Arab Emirates^ | COV-PREG-COAG | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Location | Pregnant women with confirmed COVID-19 infection with outcomes reported | Women who required critical care. N/A not available | Women who delivered, presumed healthy1 | Women with ongoing pregnancies, presumed healthy1 | Venous thrombotic events | Arterial thrombotic events | Disseminated intravascular coagulation (DIC) events | |
Total | 1063 | 132/1033 | 593 | 426 | 3 | 1 | 7 |
Case | Study number | Number requiring critical care | Number of maternal deaths | Type of arterial thrombotic events | Type of venous thrombotic events 1 = inferior vena cava 2 = pulmonary embolism 3 = DVT | Number symptomatic | Diagnosis of event made antenatally (1) or postnatally (2) | Number receiving thromboprophylaxis prior to VTE event | If thromboprophylaxis reported, what type and what dose? | D-dimer measurement (micrograms/ml normal = < 0.5) | Risk factors: PET = 1, smoker = 2, FHx VTE = 3, Age > 35 = 4, IVF = 5, twins = 6, parity > 3 = 7, BMI > 30 = 8 |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 65 | 1 | 0 | 0 | 1 | 1 | 1 | “therapeutic anticoagulation” | Not given | 7 | |
2 | 87 | 1 | 0 | 0a | 0 | 1 | 1 | enoxaparin 40 mg subcutaneously daily. BMI 41.5 | 0.57–2.82 | 4,8 | |
3 | UKOSS (107) | 1 | 1 | Basilar artery thrombosis | 2 | 1 “Deteriorating respiratory function” | 2 | 1 | Enoxaparin (prophylactic dose) | Not given | 8, |
4 | 141 | 1 | 0 | 2 | |||||||
5 | 159 | 1 | 0 | 0 | 0b | 0 | 1 | 1 | Lovenox 40 mg daily | Not given | 4,5 |
Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | Case 6 | Case 7 | Case 8 | Case 9 | Case 10 | ||
---|---|---|---|---|---|---|---|---|---|---|---|
Study number | 48 (Canada) | 48 | 67 | 67 | 50 | 118 | NUH/UHL | 155 | 101 | 81 | |
Classification of coagulopathy | DIC in pregnancy score 27 | DIC in pregnancy score 27 | Authors stated DIC | Authors stated coagulopathy | Authors state mild coagulopathy. DIC in pregnancy score 27 | Authors stated coagulopathy | Authors stated DIC | Authors stated DIC | DIC in pregnancy score 27 | Authors stated DIC | |
Maternal outcome | Recovered | Recovered | Died | Remains in Hospital | Remains on ICU | Died | Died | Recovered (after termination of pregnancy) | Remains in hospital | Recovered | |
Haematological indices | Platelets (minimum and maximum if multiple values reported) | 82 | 54 | 122–188 | 122–170 | 114 | 40–119 | 57 | 33–94 | required “10 injections of platelets) | 57 |
APTT (normal range) | 41 (18.5–29.9) | 60 (28.0–41.9) | 35.1 | PTT 30.1–30.6 | 49.3 (24–33) | PTT 44.6–27.7 | PTT 36 | ||||
Prothrombin Time | 20.2 | 10.6–10.9 | 23.9 | 12.7 | 16 | ||||||
INR | 1.0 | 1.1 | 1.7 | 0.94–0.97 | 1.8 | ||||||
Fibrinogen (g/L) Normal 2.48–5.06 (3rd trimes ster) | 2.2 | 0.8 | 1.1 | Mg/dL < 60–275 | |||||||
D Dimer (mg/L) normal 0.13–1.7 | 25.79 | > 20 | 6.5 | 19.06 | > 33.89 | ||||||
Minimum ISTH Pregnancy DIC Score with available values | 27 | 27 | 27 | N/A (postpartum) | 26 | 27 | |||||
Minimum DIC score (ISTH) | 4 | 5 | 2 | 6 | 6 |