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COVID-19 in Pregnancy: A Current Review of Global Cases
Sung Y Chae1, Adity Bhattacharyya2, Rosa Mendoza1
1Assistant Director, JFK Family Medicine Residency Program, Edison; Assistant Professor, Hackensack Meridian School of Medicine, Nutley.
Insights
Pregnant women and newborns generally experience mild COVID-19, but severe illness and mortality can occur, especially with comorbidities. Asymptomatic cases and racial disparities necessitate increased testing and policy changes.
Area of Science:
- Perinatology
- Infectious Diseases
- Public Health
Background:
- Prior coronavirus outbreaks caused significant maternal and infant morbidity and mortality.
- Concerns exist regarding the impact of COVID-19 on pregnancy outcomes.
- Understanding COVID-19's effects on pregnant individuals and neonates is crucial.
Purpose of the Study:
- To review and synthesize current research on COVID-19's impact on pregnant women and newborns.
- To identify key findings regarding maternal and neonatal health outcomes.
Main Methods:
- Literature search using "COVID-19" and "pregnancy" in Medline and Clinical Key.
- Inclusion of English-language articles with data on both mothers and newborns.
- Focus on studies reporting maternal and neonatal outcomes.
Main Results:
- Most pregnant women experience mild to moderate COVID-19, but 5% face critical illness, particularly those with comorbidities.
- Neonatal outcomes are generally favorable, with rare intrauterine vertical transmission.
- Third-trimester infections may link to preterm birth; asymptomatic cases and racial disparities are significant concerns.
Conclusions:
- COVID-19 typically presents as mild to moderate in pregnant individuals and newborns, with severe cases and mortality occurring in a minority, especially with comorbidities.
- The prevalence of asymptomatic infections underscores the need for enhanced testing and infection control.
- Observed racial disparities highlight underlying health vulnerabilities and the need for targeted research and policy interventions.
Importance:
There is great concern about the impact of COVID-19 in pregnancy due to the high morbidity and mortality associated with prior coronavirus infections.
Objective:
The objective of this review is to summarize the current literature on the impact of COVID-19 on pregnant women and their newborns.
Evidence Acquisition:
The search terms COVID-19 and pregnancy were used in Medline and Clinical Key databases. Only articles written in English with outcome data on both mothers and their newborns were incorporated.
Results:
Pregnant women generally experience COVID-19 as a mild-moderate illness. However, approximately 5% become critically ill. Women with underlying comorbidities seem more likely to experience severe morbidity. Newborns also generally have a favorable course. Vertical transmission in the intrauterine period is possible but rare. Infection control measures need to be taken to prevent transmission during the peripartum period. There is a paucity of data on infections in the first and second trimesters, but research from those infected in the third trimester indicates a possible link with preterm birth. There is a significant percentage of asymptomatic cases. Racial disparities are also being noted with disproportionate numbers of racial/ethnic minorities being affected.
Conclusions:
COVID-19 is generally experienced by pregnant women and their newborns as a mild to moderate illness, although a minority become critically ill and mortality does occur. This is more likely among those with underlying comorbidities, as in the general population. Asymptomatic cases heighten the need for increased testing and infection control measures. Racial disparities highlight underlying vulnerabilities and the need for increased research and policy changes.
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