Severe Coronavirus Infections in Pregnancy: A Systematic Review : Obstetrics & Gynecology

Secondary Logo

Journal Logo

Contents: Systematic Review

Severe Coronavirus Infections in Pregnancy

A Systematic Review

Galang, Romeo R. MD, MPH; Chang, Karen PhD, MHS; Strid, Penelope MPH; Snead, Margaret Christine PhD; Woodworth, Kate R. MD, MPH; House, Lawrence D. PhD; Perez, Mirna MSW; Barfield, Wanda D. MD, MPH; Meaney-Delman, Dana MD, MPH; Jamieson, Denise J. MD, MPH; Shapiro-Mendoza, Carrie K. PhD, MPH; Ellington, Sascha R. PhD, MSPH

Author Information
Obstetrics & Gynecology 136(2):p 262-272, August 2020. | DOI: 10.1097/AOG.0000000000004011


To inform the current coronavirus disease 2019 (COVID-19) outbreak, we conducted a systematic literature review of case reports of Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, during pregnancy and summarized clinical presentation, course of illness, and pregnancy and neonatal outcomes.


We searched MEDLINE and from inception to April 23, 2020.


We included articles reporting case-level data on MERS-CoV, SARS-CoV, and SARS-CoV-2 infection in pregnant women. Course of illness, indicators of severe illness, maternal health outcomes, and pregnancy outcomes were abstracted from included articles.


We identified 1,328 unique articles, and 1,253 articles were excluded by title and abstract review. We completed full-text review on 75, and 29 articles were excluded by full-text review. Among 46 publications reporting case-level data, eight described 12 cases of MERS-CoV infection, seven described 17 cases of SARS-CoV infection, and 31 described 98 cases of SARS-CoV-2 infection. Clinical presentation and course of illness ranged from asymptomatic to severe fatal disease, similar to the general population of patients. Severe morbidity and mortality among women with MERS-CoV, SARS-CoV, or SARS-CoV-2 infection in pregnancy and adverse pregnancy outcomes, including pregnancy loss, preterm delivery, and laboratory evidence of vertical transmission, were reported.


Understanding whether pregnant women may be at risk for adverse maternal and neonatal outcomes from severe coronavirus infections is imperative. Data from case reports of SARS-CoV, MERS-CoV, and SAR-CoV-2 infections during pregnancy are limited, but they may guide early public health actions and clinical decision-making for COVID-19 until more rigorous and systematically collected data are available. The capture of critical data is needed to better define how this infection affects pregnant women and neonates. This review was not registered with PROSPERO.

© 2020 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

Full Text Access for Subscribers:

You can read the full text of this article if you:

Access through Ovid