Abstract
There are many unknowns for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. Clinical experience of pregnancies complicated with infection by other coronaviruses e.g., Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome, has led to pregnant woman being considered potentially vulnerable to severe SARS-CoV-2 infection. Physiological changes during pregnancy have a significant impact on the immune system, respiratory system, cardiovascular function, and coagulation. These may have positive or negative effects on COVID-19 disease progression. The impact of SARS-CoV-2 in pregnancy remains to be determined, and a concerted, global effort is required to determine the effects on implantation, fetal growth and development, labor, and neonatal health. Asymptomatic infection presents a further challenge regarding service provision, prevention, and management. Besides the direct impacts of the disease, a plethora of indirect consequences of the pandemic adversely affect maternal health, including reduced access to reproductive health services, increased mental health strain, and increased socioeconomic deprivation. In this review, we explore the current knowledge of COVID-19 in pregnancy and highlight areas for further research to minimize its impact for women and their children.
Highlights
As pregnant women are at greater risk of complications and severe disease from infection with other coronaviruses, including Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS), they were identified as a vulnerable group and were advised to take additional precautions as the COVID-19 pandemic unfolded [22, 33, 143]
We evaluate the evidence of the effects of SARS-CoV-2 infection throughout pregnancy
From the current evidence base, it is difficult to draw absolute conclusions on whether pregnant women are at increased risk of severe consequences of COVID-19
Summary
In December 2019, a cluster of four cases of pneumonia of unknown etiology in Wuhan, China, were reported to the World Health Organization (WHO) [70]. Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly across the world. As pregnant women are at greater risk of complications and severe disease from infection with other coronaviruses, including Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS), they were identified as a vulnerable group and were advised to take additional precautions as the COVID-19 pandemic unfolded [22, 33, 143]. We conducted a literature search to identify all articles relating to COVID-19 in pregnancy until August 17, 2020. Search terms included combinations of coronavirus, 2019-nCoV, COVID-19, SARSCoV-2, and pregnancy and were input into Medline, Embase, Cochrane, Web of Science, and Cinahl.
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