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Published on: January 12, 2018
Risks and Preventions for Pregnant Women and Their Preterm Infants in a World with COVID-19: A Narrative Review
Abdulrahman K Ahmed1, Victor Coll Sijercic2, Reem Sayad1
1Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
Insights
The impact of COVID-19 on pregnancy and preterm birth (PTB) remains controversial, with mixed findings on PTB rates. COVID-19 infection in pregnant women increases risks, but vaccines appear safe and effective.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Neonatology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), significantly impacting pregnancy outcomes.
- The association between COVID-19 infection and preterm birth (PTB) in pregnant women is not well-established, with conflicting evidence in existing literature.
Purpose of the Study:
- To systematically review the literature on COVID-19's effects on pregnant women and preterm infants.
- To analyze the impact of COVID-19 on the incidence of preterm birth (PTB).
- To discuss the safety and efficacy of COVID-19 vaccines during pregnancy.
Main Methods:
- A systematic literature search was conducted using MEDLINE, Embase, and PubMed.
- Studies focusing on preterm births in association with COVID-19 were included.
Main Results:
- Contradictory findings exist regarding the prevalence of PTB during the COVID-19 pandemic compared to previous periods.
- COVID-19 infection during pregnancy is linked to increased rates of cesarean section, stillbirth, ICU admission, preeclampsia/eclampsia, and maternal mortality.
- Methylprednisolone is preferred over prednisolone for severe COVID-19 in pregnant women; dexamethasone is recommended for accelerating fetal lung development in cases of anticipated PTB.
Conclusions:
- COVID-19 vaccination in pregnant and lactating women elicits anti-SARS-CoV-2 immune responses.
- COVID-19 vaccination during pregnancy has not shown significant adverse reactions or outcomes for mothers or infants.
Abstract:
(1) Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is linked to increasing cases of coronavirus disease 2019 (COVID-19) around the world. COVID-19 infections have an important impact on pregnancy, preterm birth (PTB) and delivery. Although several complications have been reported in infected pregnant women, the effect of infection on PTB is controversial. The purpose of this study was to summarize the existing literature on the effects and complications of COVID-19 on the health of pregnant women and preterm babies and its impact on the incidence of PTB. We also discuss the effect of current COVID-19 vaccines during pregnancy. (2) Methods: We carried out a systematic search of MEDLINE, Embase, and PubMed for studies on preterm births associated with COVID-19. (3) Results and Conclusions: We discovered contradictory results regarding the prevalence of PTB during the pandemic compared to earlier years. While most studies indicated an increase in PTBs with COVID-19, some indicated a decline in the preterm delivery rate during this time. During pregnancy, COVID-19 infection can increase the incidence of cesarean section, stillbirth, ICU admission, preeclampsia/eclampsia, and mortality rates. In the treatment of pregnant women with severe COVID-19, methylprednisolone was favored over prednisolone, and a brief course of dexamethasone is advised for pregnant women with anticipated PTB to accelerate the development of the fetal lung. Generally, vaccination for COVID-19 in pregnant and lactating women stimulates anti-SARS-CoV2 immune responses, and it does not result in any noteworthy negative reactions or outcomes for the mother or baby.
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