COVID-19 in pregnancy

The effect of COVID-19 infection on pregnancy is not completely known because of the lack of reliable data.[1] Findings from a small study in China shows that clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported from non-pregnant adults.[2] As of March 2020, there is no evidence for vertical transmission of COVID-19 from mother to child in late pregnancy.[2] Predictions based on similar infections such as SARS and MERS suggest that pregnant women are at an increased risk of severe infection.[3]

COVID-19 in pregnancy
Risk factorsSevere infection
PreventionCovering cough, avoid interacting with sick people, cleaning hands with soap and water or sanitizer
Deaths0

Research about COVID-19 in pregnancyEdit

Little evidence exists to permit any solid conclusions about the nature of COVID-19 infection in pregnancy. A study of 9 infected women at the third trimester of pregnancy from from Wuhan, China showed that they showed fever (in six of nine patients), muscle pain (in three), sore throat (in two) and malaise (in two). Fetal distress was reported in two. None of the women developed severe COVID-19 pneumonia or died. All of them had live birth pregnancies and no severe neonatal asphyxia was observed. The samples of breast milk, amniotic fluid, cord blood and neonatal throat swab were tested for SARS-CoV-2, and all results were negative.[2] In another study on 15 pregnant women, majority of the patients presented with fever and cough, while laboratory tests yielded lymphocytopenia in 12 patients.[4] Computed tomography findings of these patients were consistent with previous reports of non-pregnant patients, consisting of ground-glass opacities at early stage.[4][5] Follow-up images after delivery showed no progression of pneumonia.[4] Media reports indicate that over 100 women with COVID-19 might have delivered, and as of March 2020, no maternal deaths have been reported.[6] Two neonates have been found to be infected with COVID-19, but the transmission has likely occurred in the postnatal period.[7]

PredictionsEdit

Since COVID-19 shows similarities to SARS-CoV and MERS-CoV, it is likely that their effect on pregnancy are similar. During the 2002–03 pandemic, 12 women who were infected with SARS-CoV were studied.[8] Four of seven had first trimester miscarriage, two of five had fetal growth restriction in the second trimester, and four of five had preterm birth. Three women died during pregnancy. None of the newborns were infected with SARS-CoV.[8] A report of ten cases of MERS- CoV infection in pregnancy in Saudi Arabia showed that the clinical presentation is variable, from mild to severe infection. The outcome was favorable in a majority of the cases, but the infant death rate was 27%.[9]

RecommendationsEdit

The Centers for Disease Control and Prevention of the United States advises pregnant women to do the same things as the general public to avoid infection, such as covering cough, avoid interacting with sick people, cleaning hands with soap and water or sanitizer.[1] There is no evidence regarding if there is vaginal shedding of the virus, so vaginal delivery may be considered if the patient has no other contraindications.[6]

ReferencesEdit

  1. ^ a b "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. 11 February 2020. Retrieved 19 March 2020.
  2. ^ a b c Chen, Huijun; Guo, Juanjuan; Wang, Chen; Luo, Fan; Yu, Xuechen; Zhang, Wei; Li, Jiafu; Zhao, Dongchi; Xu, Dan; Gong, Qing; Liao, Jing; Yang, Huixia; Hou, Wei; Zhang, Yuanzhen (7 March 2020). "Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records". The Lancet. 395 (10226): 809–815. doi:10.1016/S0140-6736(20)30360-3. ISSN 0140-6736. PMID 32151335. Retrieved 19 March 2020.
  3. ^ Favre, Guillaume; Pomar, Léo; Musso, Didier; Baud, David (22 February 2020). "2019-nCoV epidemic: what about pregnancies?". The Lancet. 395 (10224): e40. doi:10.1016/S0140-6736(20)30311-1. ISSN 0140-6736. PMID 32035511. Retrieved 19 March 2020.
  4. ^ a b c Liu, Dehan; Li, Lin; Wu, Xin; Zheng, Dandan; Wang, Jiazheng; Yang, Lian; Zheng, Chuansheng (2020-03-18). "Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis". American Journal of Roentgenology: 1–6. doi:10.2214/AJR.20.23072. ISSN 0361-803X. PMID 32186894.
  5. ^ Salehi, Sana; Abedi, Aidin; Balakrishnan, Sudheer; Gholamrezanezhad, Ali (2020-03-14). "Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients". American Journal of Roentgenology: 1–7. doi:10.2214/AJR.20.23034. ISSN 0361-803X. PMID 32174129.
  6. ^ a b Liang, Huan; Acharya, Ganesh (2020). "Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow?". Acta Obstetricia et Gynecologica Scandinavica. 99 (4): 439–442. doi:10.1111/aogs.13836. ISSN 1600-0412. PMID 32141062.
  7. ^ Qiao, Jie (7 March 2020). "What are the risks of COVID-19 infection in pregnant women?". The Lancet. 395 (10226): 760–762. doi:10.1016/S0140-6736(20)30365-2. ISSN 0140-6736. PMID 32151334. Retrieved 19 March 2020.
  8. ^ a b Wong, Shell F.; Chow, Kam M.; Leung, Tse N.; Ng, Wai F.; Ng, Tak K.; Shek, Chi C.; Ng, Pak C.; Lam, Pansy W. Y.; Ho, Lau C.; To, William W. K.; Lai, Sik T.; Yan, Wing W.; Tan, Peggy Y. H. (1 July 2004). "Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome". American Journal of Obstetrics & Gynecology. 191 (1): 292–297. doi:10.1016/j.ajog.2003.11.019. ISSN 0002-9378. PMID 15295381. Retrieved 19 March 2020.
  9. ^ Alfaraj, Sarah H.; Al-Tawfiq, Jaffar A.; Memish, Ziad A. (1 June 2019). "Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature". Journal of Microbiology, Immunology and Infection. 52 (3): 501–503. doi:10.1016/j.jmii.2018.04.005. ISSN 1684-1182. PMID 29907538.