SARS and its effects on pregnant women

MERS and its effects on pregnant women

Coronavirus Disease 2019 (COVID-19)

Implications of COVID-19 for pregnant women

Susceptibility to and severity of COVID-19 in pregnancy

Travel guidance for pregnant women

Vaccination in pregnancy

Infection control measures and diagnostic testing

Management of COVID-19 in pregnancy

Care of infants born to mothers with COVID-19

Conclusions

References

Abstract

Coronavirus Disease 2019 (COVID-19) is an emerging disease with a rapid increase in cases and deaths since its first identification in Wuhan, China, in December 2019. Limited data are available about COVID-19 during pregnancy; however, information on illnesses associated with other highly pathogenic coronaviruses (i.e., severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS)) might provide insights into COVID-19’s effects during pregnancy.

Coronaviruses cause illness ranging in severity from the common cold to severe respiratory illness and death. Currently the primary epidemiologic risk factors for COVID-19 include travel from mainland China (especially Hubei Province) or close contact with infected individuals within 14 days of symptom onset. Data suggest an incubation period of ~5 days 60 (range-2-14 days). Average age of hospitalized patients has been 49-56 years, with a third to half with an underlying illness. Children have been rarely reported. Men were more frequent among hospitalized cases (54-73%). Frequent manifestations include fever, cough, myalgia, headache, 63and diarrhea. Abnormal testing includes abnormalities on chest radiographic imaging, lymphopenia, leukopenia and thrombocytopenia. Initial reports suggest that acute respiratory 65 distress syndrome (ARDS) develops in 17-29% of hospitalized patients. Overall case fatality rate appears to be ~1%; however, early data may overestimate this rate. In two reports describing 18 pregnancies with COVID-19, all were infected in the third trimester, and clinical findings were similar to those in non-pregnant adults. Fetal distress and preterm delivery were seen in some cases. All but two pregnancies were cesarean deliveries, and testing for SARS-CoV-2 was negative on all babies tested.