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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Neonatal outcomes of maternal prenatal coronavirus infection
Istemi Han Celik1, Atakan Tanacan2, Fuat Emre Canpolat3
1Department of Pediatrics, Division of Neonatology, University of Health Sciences Türkiye; Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, 06010, Ankara, Türkiye. istemihancelik@gmail.com.
Insights
Prenatal COVID-19 infection poses risks to pregnant women and newborns, including adverse outcomes. However, vertical transmission is low, and serious neonatal issues are not typically expected, though long-term effects warrant further study.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Infectious Diseases
Background:
- The COVID-19 pandemic significantly impacted global healthcare, particularly for pregnant individuals and newborns who face heightened risks.
- Adverse pregnancy outcomes associated with COVID-19 include ICU admission, organ impairment, and mortality.
- Neonates possess unique immune systems, potentially influencing their response to SARS-CoV-2, but remain susceptible to vertical transmission and in-utero infection.
Purpose of the Study:
- To review the effects of COVID-19 on fetal and neonatal outcomes.
- To analyze transmission routes, placental impacts, and short- and long-term consequences for neonates.
- To synthesize current knowledge for preparedness during future pandemics.
Main Methods:
- Literature review and synthesis of existing data on maternal and neonatal outcomes related to SARS-CoV-2 infection.
- Analysis of study designs, patient characteristics, and clinical variables influencing reported outcomes.
- Evaluation of the impact of variants and vaccination on maternal-fetal transmission and outcomes.
Main Results:
- Prenatal SARS-CoV-2 infection is linked to adverse maternal and neonatal outcomes.
- Early pandemic interventions included C-sections, infant separation, and avoidance of breastfeeding to mitigate transmission.
- Growing evidence indicates low rates of vertical transmission and favorable short-term neonatal outcomes, with serious complications being uncommon.
Conclusions:
- While prenatal COVID-19 infection presents risks, serious fetal and neonatal outcomes are not generally expected.
- Long-term effects on neonates may involve fetal programming, requiring ongoing research.
- Lessons learned from the COVID-19 pandemic are crucial for future pandemic preparedness in maternal and neonatal care.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in life and healthcare all over the world. Pregnant women and their newborns require extra attention due to the increased risk of adverse outcomes. Adverse pregnancy outcomes include intensive care unit (ICU) admission, pulmonary, cardiac, and renal impairment leading to mortality. Immaturity and variations of the neonatal immune system may be advantageous in responding to the virus. Neonates are at risk of vertical transmission and in-utero infection. Impaired intrauterine growth, prematurity, vertical transmission, and neonatal ICU admission are the most concerning issues. Data on maternal and neonatal outcomes should be interpreted cautiously due to study designs, patient characteristics, clinical variables, the effects of variants, and vaccination beyond the pandemic. Cesarean section, immediate separation of mother-infant dyads, isolation of neonates, and avoidance of breast milk were performed to reduce transmission risk at the beginning of the pandemic in the era of insufficient knowledge. Vertical transmission was found to be low with favorable short-term outcomes. Serious fetal and neonatal outcomes are not expected, according to growing evidence. Long-term effects may be associated with fetal programming. Knowledge and lessons from COVID-19 will be helpful for the next pandemic if it occurs. IMPACT: Prenatal infection with SARS-CoV-2 is associated with adverse maternal and neonatal outcomes. Our review includes the effects of COVID-19 on the fetus and neonates, transmission routes, placental effects, fetal and neonatal outcomes, and long-term effects on neonates. There is a growing body of data and evidence about the COVID-19 pandemic. Knowledge and lessons from the pandemic will be helpful for the next pandemic if it happens.
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