METHODS AND ANALYSIS: This review will evaluate comparative studies that used VR therapy as part of interventions for children with CP. Qualitative studies, single-case studies, systematic reviews, literature reviews and guideline audits will be excluded. This review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-P) guidelines. The methodological protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The following electronic databases will be used to access related studies published between January 2012 and December 2023: MEDLINE (via EBSCOhost), Web of Science, Scopus, PubMed and Cochrane. The Peer Review of Electronic Search Strategies checklist will be employed to develop database search strategies.
ETHICS AND DISSEMINATION: This review does not require ethical approval as it uses secondary data. The findings will be published in a scientific journal. We intend to contribute to the expansion of knowledge concerning the motivational implications of VR on children with CP.
PROSPERO REGISTRATION NUMBER: International Prospective Register of Systematic Reviews (identification number CRD42023401079).
METHODS: This was a retrospective study conducted in HCTM from January 2021 to January 2022. All pregnant women admitted for COVID-19 infections were recruited. The patients' records were traced. Adverse maternal and neonatal outcomes were documented and analysed.
RESULTS: There were 172 pregnant women recruited into this study. We excluded twenty-four patients with incomplete data and nine women who delivered elsewhere. The final 139 patients were available for data analysis. The majority of women were in their third trimester of pregnancy (87.8%); however, only 5.0% and 7.2% were in the first and second trimesters, respectively. The study population had a median BMI of 29.1 kg/m2 and almost half of them had never received a COVID-19 vaccination. A sub-analysis of data concerning adverse maternal and foetal outcomes comparing early vs. severe stages of COVID-19 infection showed that severe-stage disease increased the risk of preterm birth (54.5% vs. 15.4%, p < 0.001) and preterm birth before 34 weeks (31.9% vs. 2.6%, p < 0.001) significantly. The severe-stage disease also increased NICU admission (40.9% vs. 15.4%, p = 0.017) with lower birth weight (2995 g vs. 2770 g, p = 0.017). The unvaccinated mothers had an increased risk of preterm birth before 34 weeks and this was statistically significant (11.6% vs. 2.9%, p = 0.048).
CONCLUSIONS: Adverse pregnancy outcomes such as ICU admission or patient death could occur; however, the clinical course of COVID-19 in most women was not severe and the infection did not significantly influence the pregnancy. The risk of preterm birth before 34 weeks was higher in a more severe-stage disease and unvaccinated mother. The findings from this study can guide and enhance antenatal counselling of women with COVID-19 infection, although they should be interpreted with caution in view of the very small number of included cases of patients in the first and second trimesters.