Prevalence of global preterm labor in pregnant women infected with coronavirus: A systematic review and meta-meta-analysis

Abstract

Background

Preterm labor is a key factor in neonatal morbidity and mortality globally. Therefore, in the crisis of the coronavirus pandemic, it is important to investigate the prevalence of preterm labor in mothers with COVID-19 infection.

Materials and methods

We performed, according to the PRISMA guideline, a search of the PubMed and Web of Science database on September 1, 2022, to identify systematic reviews and meta-analyses that have summarized studies that report the prevalence of preterm labor in pregnant women with COVID-19. Based on the focused search strategy and eligibility criteria, finally, 66 studies were included in this review. After critical appraisal, using Comprehensive Meta Analysis V3 software, data analysis was done. A random-effects model was employed to account for heterogeneity among studies, and publication bias was assessed. Pooled estimates and their 95% confidence intervals were reported using forest plots.

Results

Sixty-six meta-analysis studies, involving a total of 335,964 preterm labors among a sample of 2,260,032 women pregnant with coronavirus infection, were analyzed. Prevalence of preterm delivery in women infected with COVID-19 is 18.8% (lower limit = 0.148; upper limit = 0.235; CI = 95%’ df = 65; I-Squared = 99.87; Egger test = 0.40).

Conclusions

The pooled global prevalence of preterm delivery in women infected with COVID-19 is higher than the global estimate in the era before the coronavirus pandemic. Given the global burden of preterm birth, efforts should be intensified to improve the quality of care for all COVID-infected pregnant women.