{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:32:52Z","timestamp":1791505972996,"version":"4.3.4"},"reference-count":58,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Studies have suggested that cesarean birth in pregnant women with COVID\u201019 may decrease maternal adverse events and perinatal transmission. This systematic review aimed to evaluate variations in clinical presentation, laboratory findings, and maternal\/neonatal outcomes in COVID\u201019 patients who delivered vaginally versus via cesarean.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search following PRISMA guidelines was performed for studies published up to May 23, 2020, using PubMed, Web of Science, Scopus, Embase, Cochrane, Science Direct, and clinicaltrials.gov. Original retrospective and prospective studies, case reports, or case series with sufficient data for estimating the association of COVID\u201019 with different pregnancy outcomes with no language restriction and published in peer\u2010reviewed journals were included. Pooled mean and arcsine transformation proportions were applied. Next, a two\u2010arm meta\u2010analysis was performed comparing the perinatal outcomes between the study groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two studies with a total of 602 pregnant women with COVID\u201019 were included. The mean age was 31.8\u00a0years. Subgroup analysis showed that Americans had the lowest gestational age (mean\u00a0=\u00a032.7, 95%CI\u00a0=\u00a027.0\u201038.4, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and the highest incidence of maternal ICU admission (95%CI\u00a0=\u00a00.45%\u20102.20, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) of all nationalities in the study. There was no significant difference in perinatal complications, premature rupture of membrane, placenta previa\/accreta, or gestational hypertension\/pre\u2010eclampsia between women who delivered vaginally versus by cesarean. Importantly, there were also no significant differences in maternal or neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vaginal delivery was not associated with worse maternal or neonatal outcomes when compared with cesarean. The decision to pursue a cesarean birth should be based on standard indications, not COVID\u201019 status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12609","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T04:58:40Z","timestamp":1641617920000},"page":"179-193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Excess of cesarean births in pregnant women with COVID\u201019: A meta\u2010analysis"],"prefix":"10.1111","volume":"49","author":[{"given":"Mahmoud","family":"Omar","sequence":"first","affiliation":[{"name":"Division of Endocrine and Oncologic Surgery Department of Surgery School of Medicine Tulane University  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohanad R.","family":"Youssef","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Oncologic Surgery Department of Surgery School of Medicine Tulane 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