{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:10:02Z","timestamp":1790169002255,"version":"4.1.0"},"reference-count":85,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV008443"],"award-info":[{"award-number":["INV008443"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We conducted an overview of systematic reviews (SRs) summarizing the best evidence regarding the effect of COVID-19 on maternal and child health following Cochrane methods and PRISMA statement for reporting (PROSPERO-CRD42020208783).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched literature databases and COVID-19 research websites from January to October 2020. We selected relevant SRs reporting adequate search strategy, data synthesis, risk of bias assessment, and\/or individual description of included studies describing COVID-19 and pregnancy outcomes. Pair of reviewers independently selected studies through COVIDENCE web-software, performed the data extraction, and assessed its quality through the AMSTAR-2 tool. Discrepancies were resolved by consensus. Each SR\u2019s results were synthesized and for the most recent, relevant, comprehensive, and with the highest quality, by predefined criteria, we presented GRADE evidence tables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 66 SRs of observational studies out of 608 references retrieved and most (61\/66) had \"critically low\" overall quality. We found a relatively low degree of primary study overlap across SRs. The most frequent COVID-19 clinical findings during pregnancy were fever (28\u2013100%), mild respiratory symptoms (20\u201379%), raised C-reactive protein (28\u201396%), lymphopenia (34\u201380%), and pneumonia signs in diagnostic imaging (7\u201399%). The most frequent maternal outcomes were C-section (23\u201396%) and preterm delivery (14\u201364%). Most of their babies were asymptomatic (16\u201393%) or presented fever (0\u201350%), low birth weight (5\u201343%) or preterm delivery (2\u201369%). The odds ratio (OR) of receiving invasive ventilation for COVID-19 versus non-COVID-19 pregnant women was 1.88 (95% Confidence Interval [CI] 1.36\u20132.60) and the OR that their babies were admitted to neonatal intensive care unit was 3.13 (95%CI 2.05\u20134.78). The risk of congenital transmission or via breast milk was estimated to be low, but close contacts may carry risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This comprehensive overview supports that pregnant women with COVID-19 may be at increased risk of adverse pregnancy and birth outcomes and low risk of congenital transmission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0253974","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T13:40:33Z","timestamp":1624974033000},"page":"e0253974","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":91,"title":["COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5142-6122","authenticated-orcid":true,"given":"Agust\u00edn","family":"Ciapponi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Bardach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7111-5169","authenticated-orcid":true,"given":"Daniel","family":"Comand\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Berrueta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando J.","family":"Argento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Rodriguez Cairoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Santa Mar\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabra","family":"Zaraa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agustina","family":"Mazzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Buekens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"pone.0253974.ref001","author":"National COVID-19 Clinical Evidence Taskforce","year":"2020","journal-title":"Australian guidelines for the clinical care of people with COVID-19"},{"key":"pone.0253974.ref002","first-page":"m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis","volume":"370","author":"J Allotey","year":"2020","journal-title":"BMJ (Clinical research ed)"},{"key":"pone.0253974.ref003","volume-title":"Coronavirus disease (COVID-19): Pregnancy and childbirth","author":"WHO","year":"2021"},{"key":"pone.0253974.ref004","first-page":"7","article-title":"To breastfeed or not to breastfeed? 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transmission","volume":"21","author":"MA Ashraf","year":"2020","journal-title":"Journal of Reproduction and Infertility"},{"issue":"11","key":"pone.0253974.ref042","first-page":"17","article-title":"Effects of COVID-19 Infection during Pregnancy and Neonatal Prognosis: What Is the Evidence?","volume":"17","author":"AFL de Sousa","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0253974.ref043","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ajog.2020.04.013","article-title":"Coronavirus disease 2019 during pregnancy: a systematic review of reported cases","volume":"223","author":"AN Della Gatta","year":"2020","journal-title":"American Journal of Obstetrics and Gynecology"},{"issue":"2","key":"pone.0253974.ref044","article-title":"Gravidez e infec\u00e7\u00e3o por Coronav\u00edrus: desfechos maternos, fetais e neonatais - Revis\u00e3o sistem\u00e1tica^iptA Systematic Review of Pregnancy and Coronavirus Infection: Maternal, Fetal 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