Maternal and neonatal response to COVID-19

Abstract

The risk of severe acute respiratory distress syndrome-associated coronavirus-2 (SARS-CoV-2) to maternal and newborn health has yet to be determined. Several reports suggest pregnancy does not typically increase the severity of disease, however, several cases of pre-eclampsia and preterm birth have been reported. Reports of placental infection and vertical transmission are rare. Interestingly, despite lack of SARS-CoV-2 placenta productive infection there are several reports of significant abnormalities in placenta morphology. Continued research on pregnant women infected with SARS-CoV-2 and their offspring is vitally important.

Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression

“…Several original studies and systematic reviews have been completed, assessing clinical characteristics of pregnant women with COVID-19 ( 46 , 69 , 135 ). Interestingly, most studies report similar clinical characteristics and mortality rates in pregnant women with COVID-19 compared with nonpregnant women of reproductive age ( 48 ). This is in contrast to what has been observed in other respiratory viruses, including SARS-CoV ( 142 ).…”

“…This is in contrast to what has been observed in other respiratory viruses, including SARS-CoV ( 142 ). Some have suggested this is likely a result of the physiological immune adaptions that occur during pregnancy, preventing escalation to the hyperinflammatory phase of COVID-19 ( 48 ). However, despite evidence of mild COVID-19 in pregnant patients, a recent report by the CDC suggests pregnant women may be at higher risk for more severe outcomes, estimating a higher proportion of pregnant women with COVID-19 undergo hospitalization compared with nonpregnant women ( 38 ).…”

Potential impacts of COVID-19 on reproductive health: Scientific findings and social dimension

“…This suggests that the placenta could be a organ that is sensitive to the effects of COVID-19 and highlights the role of other infection mechanisms, rather than an inflammatory storm. Thus, such infection is expected to have adverse outcomes on the functions of placenta and fetal intrauterine growth ( Shanes et al, 2020 , Golden and Simmons, 2020 ).…”

The Impact of the COVID-19 Pandemic on Maternal and Perinatal Health: A Scoping Review

“…15,16 In a review of cases, Golden and Simmons hypothesized that these placental abnormalities were not a direct result of COVID -19 infection. 17…”

“…26,27 The occurrence of placental infection with the virus 15,16 and the presence of COVID-19 antibodies in neonatal blood suggest some mechanism of vertical transmission. 17 Despite this, transmission of the virus through blood is questionable. Egloff et al hypothesized that transcytosis (transcellular transport) of the virus, infected blood cell transport, and virus or infected cells in the cervicovaginal compartment were unlikely avenues for transmission in most pregnant women with COVID-19.…”