SARS-CoV-2 variants and pregnant Women: A cause for Concern?

Chionuma, Joy Onyinyechi; Onyeaka, Helen; Ekwebelem, Osmond C.; Nnaji, Nnabueze Darlington

doi:10.1016/j.jvacx.2022.100185

Cited by 5 publications

(6 citation statements)

References 17 publications

(17 reference statements)

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“…Pregnant women are at high risk of contracting COVID-19, and the impact of infection with SARS-CoV-2 during pregnancy on mothers and their unborn babies has been a topic of great concern in related research fields throughout the world [ 4 , 5 ]. Previous studies have shown that pregnant women are at increased risk of severe illness associated with COVID-19, and that COVID-19 during pregnancy is associated with an increased risk of adverse pregnancy outcomes, as well as maternal and neonatal complications [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Pregnant women undergo a series of physiological changes in various bodily systems during pregnancy. As a high-risk group within the population, they not only need to meet the challenges and uncertainties related to pregnancy status but also the challenges and uncertainties related to SARS-CoV-2, especially those involving different variants [ 5 ]. The Secretary of Primary Health Care at the Brazilian health ministry once reportedly asked Brazilian women ‘if possible’ to delay pregnancy over COVID-19 variants [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Deng

Liu

et al. 2022

IJERPH

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The aim of this study is to review the currently available data, and to explore the association of infection with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants during pregnancy with maternal and perinatal outcomes in the real world. Observational cohort studies were analyzed that described the maternal and perinatal outcomes of infection with different SARS-CoV-2 variants during pregnancy. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) for maternal and perinatal outcomes. Random effects were used to estimate the pooled odds ratios (OR) and their 95% CI for different outcomes between Delta and pre-Delta periods, and between Omicron and Delta periods. Eighteen studies, involving a total of 133,058 cases of SARS-CoV-2 infection during pregnancy (99,567 cases of SARS-CoV-2 wild type or pre-variant infection and 33,494 cases of SARS-CoV-2 variant infections), were included in this meta-analysis. Among pregnant women with SARS-CoV-2 infections, the PPs for required respiratory support, severe or critical illness, intensive care unit (ICU) admission, maternal death, and preterm birth <37 weeks were, respectively, 27.24% (95%CI, 20.51–33.97%), 24.96% (95%CI, 15.96–33.96%), 11.31% (95%CI, 4.00–18.61%), 4.20% (95%CI, 1.43–6.97%), and 33.85% (95%CI, 21.54–46.17%) in the Delta period, which were higher than those in the pre-Delta period, while the corresponding PPs were, respectively, 10.74% (95%CI, 6.05–15.46%), 11.99% (95%CI, 6.23–17.74%), 4.17% (95%CI, 1.53–6.80%), 0.63% (95%CI, 0.05–1.20%), and 18.58% (95%CI, 9.52–27.65%). The PPs for required respiratory support, severe or critical illness, and ICU admission were, respectively, 2.63% (95%CI, 0.98–4.28%), 1.11% (95%CI, 0.29–1.94%), and 1.83% (95%CI, 0.85–2.81%) in the Omicron period, which were lower than those in the pre-Delta and Delta periods. These results suggest that Omicron infections are associated with less severe maternal and neonatal adverse outcomes, though maternal ICU admission, the need for respiratory support, and preterm birth did also occur with Omicron infections. Since Omicron is currently the predominant strain globally, and has the highest rates of transmission, it is still important to remain vigilant in protecting the vulnerable populations of mothers and infants. In particular, obstetricians and gynecologists should not ignore the adverse risks of maternal ICU admission, respiratory support, and preterm births in pregnant patients with SARS-CoV-2 infections, in order to protect the health of mothers and infants.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Deng

Liu

et al. 2022

IJERPH

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“…In pregnant women, vaccination is associated with fewer COVID-19 cases during pregnancy. 40 41 Furthermore, pregnant women vaccinated against SARS-CoV-2 have a reduced risk of severe or critical presentation of COVID-19 compared to those not vaccinated. 42 …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Risk of Hypoxemia Development in Women Infected with SARS-CoV-2 during Pregnancy

Sohn,

Choi,

Yun

et al. 2024

Yonsei Med J

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Purpose There is limited information on the clinical characteristics and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy. The clinical features and risk factors for hypoxemia development were investigated in pregnant women with coronavirus disease-2019 (COVID-19). Materials and Methods From August 2020 to February 2022, we performed a retrospective cohort study of 410 pregnant women with COVID-19. The clinical characteristics and prognoses were compared between pregnant COVID-19 patients requiring oxygen and those who did not. Results Of 410 patients, 100 (24.4%) required oxygen therapy. Among them, fever [163 (52.6%) vs. 81 (81.0%), p <0.001] and cough [172 (56.4%) vs. 73 (73.0%), p =0.003] were more frequently observed than in non-oxygen group. The proportion of unvaccinated women was higher in oxygen group than in non-oxygen group [264 (85.2%) vs. 98 (98.0%), p =0.003]. During the Omicron wave, patients were more likely to have no oxygen requirement [98 (31.6%) vs. 18 (18.0%), p =0.009]. The risk of hypoxemic respiratory difficulty increased if SARS-CoV-2 infection occurred during the third trimester [adjusted odds ratio (aOR) 5.083, 95% confidence interval (CI): 1.095–23.593, p =0.038] and C-reactive protein (CRP) was elevated (≥1.0 mg/dL) at admission (aOR 5.878, 95% CI: 3.099–11.146, p <0.001). The risk was higher in unvaccinated patients (aOR 5.376, 95% CI: 1.193-24.390, p =0.028). However, the risk was lower in patients during the Omicron wave (aOR 0.498, 95% CI: 0.258–0.961, p =0.038). Conclusion A quarter of SARS-CoV-2-infected women developed hypoxemic respiratory difficulty during pregnancy. SARS-CoV-2 infection during the third trimester, CRP elevation at admission, and no vaccination increased the risk of hypoxemia in pregnant women.

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“…1 Pregnancy is a unique status that is accompanied by alterations in immune function to protect the developing fetus; these changes may affect the clearance of infectious agents, especially viruses. 2 In addition, total lung capacity is reduced in pregnancy, thus increasing a woman's susceptibility to severe respiratory infections. 3 Therefore, the impact of COVID-19 on pregnant women and neonates is of significant interest globally.…”

Section: Introductionmentioning

confidence: 99%

“…More than 641 million cases and 6.6 million deaths were reported as of December 2022 1 . Pregnancy is a unique status that is accompanied by alterations in immune function to protect the developing fetus; these changes may affect the clearance of infectious agents, especially viruses 2 . In addition, total lung capacity is reduced in pregnancy, thus increasing a woman’s susceptibility to severe respiratory infections 3 .…”

Section: Introductionmentioning

confidence: 99%

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

et al. 2023

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Pregnancy is a physiological state that predisposes women to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a disease that can cause adverse maternal and perinatal outcomes. The severity of coronavirus disease 2019 (COVID-19) disease is known to vary by viral strain; however, evidence for the effects of this virus in pregnant women has yet to be fully elucidated. In this review, we describe maternal and perinatal outcomes, vaccination, and vertical transmission, among pregnant women infected with the different SARS-CoV-2 variants identified to date. We also summarize existing evidence for maternal and perinatal outcomes in pregnant women with specific information relating to SARS-CoV-2 variants. Our analysis showed that Omicron infection was associated with fewer severe maternal and perinatal adverse outcomes while the Delta variant was associated with worse pregnancy outcomes. Maternal deaths arising from COVID-19 were found to be rare (<1.0%), irrespective of whether the virus was a wild-type strain or a variant. Severe maternal morbidity was more frequent for the Delta variant (10.3%), followed by the Alpha (4.7%), wild-type (4.5%), and Omicron (2.9%) variants. The rates of stillbirth were 0.8%, 4.1%, 3.1%, and 2.3%, respectively, in pregnancies infected with the wild-type strain, Alpha, Delta, and Omicron variants, respectively. Preterm birth and admission to neonatal intensive care units were more common for cases with the Delta infection (19.0% and 18.62%, respectively), while risks were similar for those infected with the wild-type (14.7% and 11.2%, respectively), Alpha (14.9% and 13.1%), and Omicron variants (13.2% and 13.8%, respectively). As COVID-19 remains a global pandemic, and new SARS-CoV-2 variants continue to emerge, research relating to the specific impact of new variants on pregnant women needs to be expanded.

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SARS-CoV-2 variants and pregnant Women: A cause for Concern?

Cited by 5 publications

References 17 publications

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Clinical Characteristics and Risk of Hypoxemia Development in Women Infected with SARS-CoV-2 during Pregnancy

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

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