SARS-CoV-2 in Pregnancy: Fitting Into the Existing Viral Repertoire.

Roopali Rajput,Jitender Sharma

doi:10.3389/fgwh.2021.647836

Roopali Rajput, Jitender Sharma

Open Access

https://doi.org/10.3389/fgwh.2021.647836

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Abstract

The risk of viral infection during pregnancy is well-documented; however, the intervention modalities that in practice enable maternal-fetal protection are restricted by limited understanding. This becomes all the more challenging during pandemics. During many different epidemic and pandemic viral outbreaks, worse outcomes (fetal abnormalities, mortality, preterm labor, etc.) seem to affect pregnant women than what has been evident when compared to non-pregnant women. The condition of pregnancy, which is widely understood as “immunosuppressed,” needs to be re-understood in terms of the way the immune system works during such a state. The immune system gets transformed to accommodate and facilitate fetal growth. The interference of such supportive conversion by viral infection and the risk of co-infection lead to adverse fetal outcomes. Hence, it is crucial to understand the risk and impact of potent viral infections likely to be encountered during pregnancy. In the present article, we review the effects imposed by previously established and recently emerging/re-emerging viral infections on maternal and fetal health. Such understanding is important in devising strategies for better preparedness and knowing the treatment options available to mitigate the relevant adverse outcomes.

Highlights

The present review is focused on enumerating various viral infections prevalent during pregnancy and the associated risks to maternal and fetal health (Table 1) with special reference to the SARS-CoV-2 infection
Risk to the Developing Fetus One of the major concerns of the medical fraternity during COVID-19 has been the vertical transmission of the SARS-CoV2 infection and the adverse fetal outcomes
The role of virus infections in increasing morbidity and mortality during pregnancy is well-perceived, yet limited information is available on the mechanism of pregnancyled maternal responses to viral invasion

Summary

Introduction

As evident during the 1918 and 1957 flu pandemics, pregnant women exhibited high mortality rates [44, 45] and adverse pregnancy outcomes like spontaneous abortion and preterm birth [44, 46]. Risk to the Developing Fetus The most common adverse fetal outcomes include congenital viral infection, which occurs in about 0.5% of cases [62]. Risk to the Mother and the Developing Fetus Primary VSV infection in pregnant women causes considerable maternal and fetal morbidity and mortality.

Results

Conclusion