Abstract
Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-to-child transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.
Highlights
Coronavirus disease 2019 (COVID-19) has emerged as the most pressing current global health issue
A retrospective study conducted in Saudi Arabia between 2012 and 2016 included five pregnant women infected with Middle East respiratory syndrome (MERS)-CoV during the second or third trimester of pregnancy, all requiring intensive care unit (ICU) care and showing adverse pregnancy outcomes[62]
The results suggested the possibility of vertical transmission of human coronaviruses, in particular HCoV-229E, which was detected in three out of four newborn gastric samples whose mothers tested positive in vaginal samples collected at delivery
Summary
Rodriguez-Morales , Universidad Tecnológica de Pereira, Pereira, Colombia. 2. Caterina Montagnoli , Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland. Any reports and responses or comments on the article can be found at the end of the article. Epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice. Covid, infection, pregnancy, neonate, outcomes, vertical transmission. This article is included in the Emerging Diseases and Outbreaks gateway. This article is included in the Coronavirus collection
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