Clinical update on COVID-19 in pregnancy: A review article

J Obstet Gynaecol Res. 2020 Aug;46(8):1235-1245. doi: 10.1111/jog.14321. Epub 2020 Jun 4.

Abstract

The data pertaining to the COVID-19 pandemic has been rapidly evolving since the first confirmed case in December 2019. This review article presents a comprehensive analysis of the current data in relation to COVID-19 and its effect on pregnant women, including symptoms, disease severity and the risk of vertical transmission. We also review the recommended management of pregnant women with suspected or confirmed COVID-19 and the various pharmacological agents that are being investigated and may have a role in the treatment of this disease. At present, it does not appear that pregnant women are at increased risk of severe infection than the general population, although there are vulnerable groups within both the pregnant and nonpregnant populations, and clinicians should be cognizant of these high-risk groups and manage them accordingly. Approximately 85% of women will experience mild disease, 10% more severe disease and 5% critical disease. The most common reported symptoms are fever, cough, shortness of breath and diarrhea. Neither vaginal delivery nor cesarean section confers additional risks, and there is minimal risk of vertical transmission to the neonate from either mode of delivery. We acknowledge that the true effect of the virus on both maternal and fetal morbidity and mortality will only be evident over time. We also discuss the impact of social isolation can have on the mental health and well-being of both patients and colleagues, and as clinicians, we must be mindful of this and offer support as necessary.

Keywords: COVID-19 and breastfeeding; COVID-19 and pregnancy; coronavirus and pregnancy.

Publication types

  • Review

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / psychology
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / transmission
  • Cost of Illness
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Maternal Mortality
  • Mental Health
  • Morbidity
  • Pandemics
  • Pneumonia, Viral / psychology
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / transmission
  • Pregnancy
  • Pregnancy Complications, Infectious / therapy*
  • Prenatal Care
  • SARS-CoV-2
  • Thromboembolism / prevention & control