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A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19
1Faculty of Medicine, The University of British Columbia, Vancouver, Canada.
Insights
COVID-19 poses risks to pregnant individuals and newborns, including severe disease and preterm birth. Management requires careful assessment, and infection control is crucial due to potential spread by asymptomatic cases.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- COVID-19 infection presents unique risks to the maternal-fetal/newborn unit.
- Understanding the spectrum of disease and transmission is critical for effective management.
Purpose of the Study:
- To review current literature on COVID-19 in pregnancy.
- To summarize maternal, fetal, and newborn infections, management, and prevention strategies.
Main Methods:
- Narrative review of contemporary and cumulative publications.
- Synthesis of data on maternal disease spectrum, pregnancy outcomes, and neonatal infections.
Main Results:
- COVID-19 can cause severe maternal disease and preterm delivery; comorbidities increase risk.
- Congenital infection data are limited, but placental compromise is a concern.
- Newborn infections are generally mild, and effective antiviral therapies are lacking.
Conclusions:
- COVID-19 in pregnancy requires serious consideration due to maternal and fetal risks.
- Delivery mode decisions must balance maternal risk and patient preferences.
- Asymptomatic transmission complicates infection control, necessitating vigilance.
Abstract:
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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