Relationship between pregnancy and coronavirus: what we know

Forestieri, Stefano; Marcialis, Maria Antonietta; Migliore, Lucia; Panisi, Cristina; Fanos, Vassilios

doi:10.1080/14767058.2020.1771692

Cited by 30 publications

(29 citation statements)

References 57 publications

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“…These data not just confronted with initial papers suggesting that pregnant women have a similar or lower risk for COVID-19 severity than the general population, but also doubles the hospitalization rate (15.8 À 21.9%) and ICU admission percentage (1.3 À 2.2%) reported for female patients in the same age range in Spain [12]. Therefore, obstetric patients could be considered as a risk group for COVID-19 severity, as expected, due to their susceptibility to viral infections and pneumonia development, although the ICU admission and mortality rates seem to be lower than SARS-CoV and MERS-CoV epidemics [13].…”

Section: Discussionmentioning

confidence: 86%

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

Barbero

Mugüerza

Herraı̀z

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Background: There is little evidence about how novel coronavirus (SARS-CoV-2) affects pregnant women and their newborns. Comparisons with other members of the coronavirus family responsible for severe acute respiratory syndrome (SARS) have been done to predict maternal and neonatal outcomes; however, more information is required to establish clinical patterns, disease evolution and pregnancy prognosis in this group of patients. Methods: This paper is reporting a series of 91 women diagnosed with SARS-CoV-2 infection during pregnancy and puerperium. The analysis showed that 40 patients developed pneumonia, bilateral in most cases, with a 46.2% rate of hospitalization and 4 patients requiring intensive care unit (ICU) admission. In confront with previous publications, we have found a higher rate of coronavirus disease (COVID-19) severe forms, even when compared to non-pregnant women with the same baseline characteristics. We have analyzed the demographic characteristics, pregnancy-related conditions and presenting symptoms to identify features that could determine which patients will need hospitalization because of COVID-19 (Group 1-G1) and those who not (Group 2-G2). We have found that obesity and Latin-American origin behave as risk factors: OR: 4.3; 95% CI: 1.4-13.2, and OR: 2.6; 95% CI: 1.1 À 6.2, respectively. Among the 23 patients that delivered with active SARS-CoV-2, the overall rate of cesarean section (CS) and preterm birth were 52.2% and 34.8%, respectively, but we observed that the rate of CS was even higher in G1 compared to G2: 81.8% versus 25%, p ¼ .012. However, prematurity was equally distributed in both groups and only one preterm delivery was determined by poor maternal condition. There were no deaths among the patients neither their newborns. Conclusion: In conclusion, the results of our cohort reveal that SARSC-CoV-2 infection may not behave as mild as suggested during pregnancy, especially when factors as obesity or Latin-American origin are present. No evidence of late vertical transmission was noticed but prematurity and high CS rate were common findings, although it is difficult to establish any causality between these conditions and COVID-19. Further evidence is required to establish if pregnancy itself can lead to severe forms of COVID-19 disease and whether risk factors for the general population are applicable to obstetric patients. Until larger studies are available, pregnant women should be monitored carefully to anticipate severe complications.

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Section: Discussionmentioning

confidence: 86%

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

Barbero

Mugüerza

Herraı̀z

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

View full text Add to dashboard Cite

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“…In previous studies on SARS and MERS, complications such as abortion and miscarriage have been observed in infected pregnant women [29]. In another study on pregnancy evaluating the effect of other coronaviruses known to infect humans, the vertical transmission of SARS CoV could not be demonstrated and findings of thrombotic vasculopathy resulting in decreased fetal perfusion were detected in placental studies on this virus [60]. Severe complications such as perinatal death, premature birth, intrauterine growth retardation in pregnant women infected with SARS CoV have been observed in previous studies, and SARS CoV-2 infection may have similar perinatal outcomes [58].…”

Section: Discussionmentioning

confidence: 99%

“…Fever, the most common symptom in pregnant women with COVID-19, can damage the fetal neurons and lead to negative neurodevelopmental outcomes. Therefore, long-term follow-up may be required for the babies of women with COVID-19 during their pregnancy [60].…”

Section: Discussionmentioning

confidence: 99%

Vertical transmission of SARS CoV-2: a systematic review

Deniz

Tezer

2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: The aim of this study is to review the current evidence on the vertical transmission of SARS CoV-2. Methods: Combination of the following keywords; COVID-19, SARS CoV-2, placenta, vertical transmission, intrauterine infection, breast milk were searched in databases. Results: In the 50 studies included, 17 newborns testing positive for SARS CoV-2 by RT-PCR were reported. In three neonates, SARS-CoV-2 IgG and IgM levels were elevated. Eight placental tissues testing positive for the virus were reported. Three positive RT-PCR results of test of breast milk have been reported recently. One amniotic fluid testing positive was reported. Conclusion: Possible vertical transmission of SARS CoV-2 has been observed in some studies currently. More RT-PCR tests on amniotic fluid, placenta, breast milk and cord blood are required.

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“…Not only IFN-γ and IL-1, but also IL-4 and IL-10 are also present in the blood. 37 In the pregnant population, the pregnancy itself does not appear to be an aggravating factor and may also be related to the unique immune status during pregnancy.…”

Section: Maternal-fe Tal Immunit Y and Covid -19 Infec Ti Onmentioning

confidence: 99%

Pregnancy with COVID‐19: Management considerations for care of severe and critically ill cases

Chen

Jiang

Zhao

2020

American J Rep Immunol

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has been spreading globally, causing over 340 000 deaths. 1 Based on the previous knowledge of two notable coronavirus outbreaks, the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), it is suggested that pregnant women are particularly susceptible to adverse outcomes, including the need for endotracheal intubation, admission to an intensive care unit (ICU), acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), and even death. 2-4 Also, there is combined with a high incidence of adverse fetal outcomes, including stillbirth, fetal growth restriction, and preterm birth. However, current research suggests that maternal severity with COVID-19 is similar to that of non-pregnant women, with a rate of severe pneumonia at 0%-18%. 5,6 A few critically ill cases have also been reported, causing maternal death and fetal loss. This may indicate that the effect of novel coronavirus (COVID-19) infection on pregnant women may be different from that of SARS and MERS. It is well known that most pregnancy complications, such as hypertensive disorders of pregnancy, will be relieved after the termination of pregnancy. But for COVID-19, we found that postpartum exacerbation presented due to short-term pathophysiological changes immediately after delivery. 7 Gestational weeks of infection, the maturity of the fetus, disease severity, and postpartum exacerbation make the management of severe and critically ill cases of pregnant women with COVID-19 more difficult. This article is mainly to explore those issues and make some clinical suggestions.

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Relationship between pregnancy and coronavirus: what we know

Cited by 30 publications

References 57 publications

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19

Vertical transmission of SARS CoV-2: a systematic review

Pregnancy with COVID‐19: Management considerations for care of severe and critically ill cases

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