摘要：Pregnant women experience physiological changes such as pulmonary adaptation due to an elevated diaphragm and altered cell immunity. These factors can predispose pregnant women to enhanced susceptibility to severe viral pneumonia infection, leading to adverse pregnancy outcomes associated with increased mortality and morbidity in neonates. Currently, the COVID-19 pandemic has reported over 230 million cases reported globally and generated evidence on raising concerns about maternal infection on the added risk of adverse neonatal outcomes. The review aims to evaluate the effects of COVID- 19 on neonatal outcomes of infected pregnant women. We conducted the systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. To identify relevant articles based on the inclusion and exclusion criteria on COVID-19 infected pregnancies and the neonatal outcomes, we searched four databases (PubMed, Embase, Scopus and Web of Science) from January 01, 2020 to June 20, 2021 by using medical subject heading and keywords under the PECO concept (P = pregnant women, E = COVID-19, O = neonatal outcome). We also assessed the risk of bias of the selected articles. We found that newborns of COVID-19 positive mothers are more likely to be born prematurely and by caesarean section. They need NICU admissions mainly due to prematurity related to maternal COVID-19 status at delivery. We did not find any evidence linking maternal COVID-19 status to low Apgar score, low birthweight, neonatal resuscitation at birth and neonatal death. Neonatal SARS-CoV-2 positive status was infrequently reported. The possibility of vertical transmission was raised, which may contribute to a large number of preterm births and caesarean deliveries in the COVID-19 positive mothers, but there is a paucity of evidence on vertical transmission. There is a shift in focus from vertical to horizontal transmission in the case of neonatal COVID-19 infection, thereby emphasizing the implementation of safety precautions while balancing the need to allow breastfeeding and mother-to-infant skin contact. This systematic review provides evidence on the necessity of close monitoring of neonates of COVID-19 positive mothers and taking preventive measures against the acquisition of COVID-19 in neonates.
