A Meta-Analysis for Risk and Prevalence of Preeclampsia among Pregnant Women with COVID-19

Preeclampsia and SARS-CoV-2 infection are both life-threatening disorders when they occur in pregnancy and are similarly characterized by systemic immune activation and having a deleterious effect on maternal endothelial cells. During the COVID-19 pandemic there have been reports of preeclampsia or a pre-eclampsia-like syndrome occurring in pregnant women with SARS-COV-2 infection. Here, we carried a meta-analysis to estimate the risk and prevalence of preeclampsia and SARS-COV-2 infection in pregnant women. A comprehensive literature search was carried out in PubMed, Web of Sciences, Scopus and CNKI to identify all relevant studies published up to 30 February 2020. All studies reported on prevalence of preeclampsia in pregnant women with SARS-CoV-2 infection were selected. A total of 10 case-control studies and 15 case series met our inclusion criteria. Pooled data revealed that there was no significant difference between infected pregnant women and uninfected pregnant women for risk of preeclampsia (OR=1.676, 95% CI 0.679-4.139, p=0.236). Stratified analysis revealed significant risk in the infected Asian pregnant women (OR=2.637, 95% CI 1.030-6.747, p=0.043), but not in Caucasian. The prevalence of preeclampsia was 8.2% (95% CI 0.057-0.117) in infected pregnant women with COVID-19 in overall population. Its prevalence was the highest in North America (10.7%) followed by Asian (7.9%), Caucasian (6.7%), European (4.9%) and West Asia (2.6%) infected pregnant women. Our pooled data showed that the prevalence of preeclampsia in pregnant women with SARS-COV-2 infection was 8.2%. However, there was no increased risk for occurrence of preeclampsia among pregnant women with SARS-COV-2 infection.