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.

Vaccines
|March 30, 2023
PubMed

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.

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