Pregnancy and COVID-19: past, present and future

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Maternal-Fetal Medicine

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is linked to increased adverse maternal and perinatal outcomes.
• Vertical transmission of SARS-CoV-2 during pregnancy is infrequent.
• Early pandemic management of pregnant COVID-19 patients was often delayed or overly cautious.

Purpose of the Study:

• To review the current evidence on managing pregnant women with coronavirus disease 2019 (COVID-19).
• To emphasize that standard treatments should not be withheld from pregnant individuals.
• To advocate for revised infection control measures in obstetrics.

Main Methods:

• Review of current scientific evidence and clinical guidelines regarding COVID-19 in pregnancy.
• Analysis of management strategies employed during the early pandemic.
• Evaluation of safety data for COVID-19 vaccination in pregnant populations.

Main Results:

• COVID-19 management in pregnant women should align with non-pregnant individuals, including antiviral therapy, dexamethasone, and anticoagulation.
• Cesarean sections were sometimes unnecessarily performed; vaginal delivery can be considered for asymptomatic women.
• COVID-19 vaccines are safe and recommended during pregnancy, with accumulating safety data showing no concerns.

Conclusions:

• Strict infection control measures in obstetrics need to be eased, stratifying risk based on maternal symptoms.
• Lessons learned from the COVID-19 pandemic are essential for preparing future pandemic responses in maternal care.
• Policymakers and healthcare leaders must develop strategies to ensure safe maternal care during global emergencies.