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An update on COVID-19 and pregnancy
- Source :
- American Journal of Obstetrics and Gynecology
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Physiologic, mechanical and immunologic alterations in pregnancy could potentially affect susceptibility to and severity of COVID-19 during pregnancy. Due to lack of comparable incidence data and challenges with disentangling differences in susceptibility from different exposure risks, data are insufficient to determine whether pregnancy increases susceptibility to SARS-CoV-2 infection. Data support pregnancy as a risk factor for severe disease associated with COVID-19; some of the best evidence comes from the Centers for Disease Control and Prevention’s (CDC’s) COVID-19 surveillance system, which reported that pregnant persons were more likely to be admitted to an intensive care unit (ICU), require invasive ventilation, require extracorporeal membrane oxygenation, and die compared with nonpregnant women of reproductive age. Although intrauterine transmission of SARS-CoV-2 has been documented, it appears to be rare, possibly related to low levels of SARS-CoV-2 viremia and decreased co-expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) needed for SARS-CoV-2 entry into cells in the placenta. Evidence is accumulating that SARS-CoV-2 infection during pregnancy is associated with a number of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth, especially among pregnant persons with severe COVID-19 disease. In addition to the direct impact of COVID-19 on pregnancy outcomes, there is evidence that the pandemic and its effects on healthcare systems have had adverse effects on pregnancy outcomes, such as increased stillbirths and maternal deaths. These trends may represent widening disparities and an alarming reversal of recent improvements in maternal and infant health. All three COVID-19 vaccines currently available under an Emergency Use Authorization by the United States Food and Drug Administration can be administered to pregnant or lactating persons, with no preference for vaccine type. Although safety data in pregnancy are rapidly accumulating and no safety signals in pregnancy have been detected, additional information about birth outcomes, particularly among persons vaccinated earlier in pregnancy, are needed.
- Subjects :
- medicine.medical_specialty
COVID-19 Vaccines
Coronavirus Disease 2019 (COVID-19)
perinatal infection
Disease
Severity of Illness Index
Preeclampsia
law.invention
Pre-Eclampsia
Pregnancy
Risk Factors
newborn
law
medicine
Humans
pneumonia
Healthcare Disparities
Pregnancy Complications, Infectious
Risk factor
Adverse effect
Fetus
SARS-CoV-2
Obstetrics
business.industry
COVID-19
preterm birth
Obstetrics and Gynecology
Stillbirth
medicine.disease
Intensive care unit
Infectious Disease Transmission, Vertical
fetus
maternal death
Premature Birth
Female
vertical transmission
Maternal death
Disease Susceptibility
fetal death
Expert Review
business
Subjects
Details
- ISSN :
- 00029378
- Volume :
- 226
- Database :
- OpenAIRE
- Journal :
- American Journal of Obstetrics and Gynecology
- Accession number :
- edsair.doi.dedup.....cbcc9a5728faa5cbd39d168ae775ef86