Effects of COVID-19 Infection during Pregnancy and Neonatal Prognosis: What Is the Evidence?

Abstract

Background: This study’s aims are to assess the current evidence presented in the literature regarding the potential risks of COVID-19 infection among pregnant women and consequent fetal transmission. Methods: a systematic literature review assessing papers published in the most comprehensive databases in the field of health intended to answer the question, “What are the effects of COVID-19 infection during pregnancy, and what is the neonatal prognosis?” Results: 49 papers published in 2020 were eligible, presenting low levels of evidence. A total of 755 pregnant women and 598 infants were assessed; more than half of pregnant women had C-sections (379/65%). Only 493 (82%) infants were tested for SARS-CoV-2, nine (2%) of whom tested positive. There is, however, no evidence of vertical transmission based on what has been assessed so far, considering there are knowledge gaps concerning the care provided during and after delivery, as well as a lack of suitable biological samples for testing SARS-CoV-2. Conclusions: We cannot rule out potential worsening of the clinical conditions of pregnant women infected with SARS-CoV-2, whether the infection is associated with comorbidities or not, due to the occurrence of respiratory disorders, cardiac rhythm disturbances, and acid-base imbalance, among others. We recommend relentless monitoring of all pregnant women in addition to testing them before delivery or the first contact with newborns.

SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium

“…Since the outbreak of the virus, several papers have been published on adverse outcomes of perinatal COVID-19, including miscarriage, fetal distress, preterm delivery, and maternal and neonatal death [3,11,24,25]. Larger cohorts and routine testing of all pregnant women are needed to correctly estimate the percentage of asymptomatic women and to calculate reliable prevalence and risk estimates [17,26,27].…”

Pregnancy and Childbirth in the COVID-19 Era—The Course of Disease and Maternal–Fetal Transmission

“…These changes create an increased sensitivity to develop infections, especially in the first trimester, but at any point in pregnancy, infections by virus can negatively affect pregnant women [ 19 ]. Beyond disease symptoms, these infections increase the risk of developing complications in the mother and newborn (e.g., premature delivery, restriction of intrauterine growth, and spontaneous abortion) [ 20 ]. Previous study indicated that many viruses cause more severe symptoms when they develop in pregnant women, including e.g., hepatitis E virus (HEV) [ 21 ], dengue virus [ 22 ], and H1N1 influenza virus [ 23 ].…”

COVID-19 during pregnancy should we really worry from vertical transmission or rather from fetal hypoxia and placental insufficiency? A systematic review and meta -analysis

“…This report is by far the largest systematic review to be implemented in this context, not only regarding the number of mother-infant pairs, but also the targeted outcome parameters. The largest report preceding us is De Sousa et al report 81 .…”