Abstract
Medical care is predicated on 'do no harm', yet the urgency to find drugs and vaccines to treat or prevent COVID-19 has led to an extraordinary effort to develop and test new therapies. Whilst this is an essential cornerstone of a united global response to the COVID-19 pandemic, the absolute requirements for meticulous efficacy and safety data remain. This is especially pertinent to the needs of pregnant women; a group traditionally poorly represented in drug trials, yet a group at heightened risk of unintended adverse materno-fetal consequences due to the unique physiology of pregnancy and the life course implications of fetal or neonatal drug exposure. However, due to the complexities of drug trial participation when pregnant (be they vaccines or therapeutics for acute disease), many clinical drug trials will exclude them. Clinicians must determine the best course of drug treatment with a dearth of evidence from either clinical or preclinical studies, where at least in the short term they may be more focused on the outcome of the mother than of her offspring.
Highlights
Since the beginning of 2020, when most of us had not heard of COVID-19, as of 8 October 2020,1 there have been over 36 million cases of SARS-CoV-2 and 1 million deaths from COVID-19 globally
The principles of developmental origins of health and disease (DOHaD) highlight the importance of taking a life course approach and understanding the mechanisms linking exposures during pregnancy on offspring health in infancy, childhood, adulthood and old age,[63,64,65] and this must be considered in the case of COVID-19
Treatment of COVID-19 represents a profound challenge to physicians across the globe
Summary
Berry[2], Pravin Hissaria[3], Jack R.T. Darby[1,4] and Janna L. Morrison[1,4]. Cite this article: Wiese MD, Berry MJ, Hissaria P, Darby JRT, and Morrison JL. COVID-19: can we treat the mother without harming her baby? Journal of Developmental Origins of Health and Disease doi: 10.1017/ S2040174420001403 COVID-19: can we treat the mother without harming her baby? Journal of Developmental Origins of Health and Disease doi: 10.1017/ S2040174420001403
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