J Clin Gynecol Obstet
Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
Journal website https://www.jcgo.org

Editorial

Volume 10, Number 2, June 2021, pages 33-34


COVID-19 in Pregnancy: What We Have Learned in a Year

Mauricio La Rosaa, b, d, Jack Ludmirc

aDepartment of Obstetrics and Gynecology, British American Hospital, Lima, Peru
bDepartment of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
cDepartment of Obstetrics and Gynecology and Population Health, Thomas Jefferson University, Philadelphia, PA, USA
dCorresponding Author: Mauricio La Rosa, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA

Manuscript submitted March 22, 2021, accepted March 26, 2021, published online May 18, 2021
Short title: COVID-19 in Pregnancy
doi: https://doi.org/10.14740/jcgo736

It has been a year since the beginning of the pandemic, and more than 120 million people around the world have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Our knowledge of this virus has developed at an unprecedented speed. Initially, studies reported that the risk of morbidity and mortality from coronavirus disease 2019 (COVID-19) in pregnant people was similar to the non-pregnant population [2]. Nevertheless, after months of data collection around the world it became clear that pregnancy was a risk factor for severe and critical COVID-19 [3, 4].

The symptomatology of COVID-19 in pregnant people has been evaluated in several studies. We now know that more than 75% of pregnant patients diagnosed with SARS-CoV-2 infection have an asymptomatic course [5]. As with non-pregnant people, the most common complaints of COVID-19 in symptomatic pregnant people are cough, headaches, muscle pain, and fever [3].

The risks of COVID-19 during pregnancy are mainly maternal. Compared to non-pregnant women, pregnant people are three times more likely to be admitted to intensive care unit and 2.7 times more likely to require mechanical ventilation. Unfortunately, pregnancy is associated with a 70% increased risk of death from COVID-19 [3]. Other independent risk factors for severe and critical disease in pregnancy include 35 years old or older, pregestational diabetes, chronic hypertension, and obesity [5].

COVID-19 is associated with higher rates of preterm birth, both iatrogenic and spontaneous, and cesarean delivery. The risk of preterm birth is as high as 60% in critical cases [4]. A few studies have looked at the association between hypertensive disorders of pregnancy and SARS-CoV-2 infection with varying results [4-6].

Prevention is still the most important strategy to decrease maternal morbidity and mortality. Pregnant people should follow the current recommendations of social distancing, washing hands and using masks. During the last months, attention has been taken to vaccination. Unfortunately, pregnant and lactating people were excluded from the initial trials. Recently, a report from the Centers for Disease Control and Prevention (CDC) showed that vaccination with the current Food and Drug Administration (FDA)-approved messenger ribonucleic acid (mRNA) vaccines was not associated with adverse maternal or fetal outcomes [7]. Based on current data, the American College of Obstetrics and Gynecologists and the Society of Maternal Fetal Medicine strongly recommend that pregnant and lactating people have access to COVID-19 vaccines regardless of gestational age. The decision should be made in conjunction with the patient, based on potential benefits and unknown risks.

Finally, adequate prenatal care during this pandemic is crucial. If possible, prenatal care should be a combination of face-to-face and telemedicine appointments. When face-to-face is required, several measures should take place to decrease the risk of infection, including open waiting areas, decreasing the waiting time, hand sanitizer available and screening of symptoms for every patient and staff member.

Acknowledgments

None to declare.

Financial Disclosure

None to declare.

Conflict of Interest

None to declare.

Author Contributions

All the authors contributed to the preparation of manuscript, reviewed and approved the final version of the manuscript.

Data Availability

The authors declare that data supporting the findings of this study are available within the article.


References▴Top 
  1. COVID-19 Map - Johns Hopkins Coronavirus Resource Center 2020. Available from: https://coronavirus.jhu.edu/map.html.
  2. Osanan GV, Escobar MF. Ludmir, J. Do not forget our pregnant women during the COVID-19 pandemic. Women & health. 2020;60(9):959-962.
    doi pubmed
  3. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, Woodworth KR, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-1647.
    doi pubmed
  4. Adhikari EH, Moreno W, Zofkie AC, MacDonald L, McIntire DD, Collins RRJ, Spong CY. Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Netw Open. 2020;3(11):e2029256.
    doi pubmed
  5. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, Debenham L, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.
    doi pubmed
  6. Rosenbloom JI, Raghuraman N, Carter EB, Kelly JC. Coronavirus disease 2019 infection and hypertensive disorders of pregnancy. Am J Obstet Gynecol. 2021.
    doi
  7. CDC. COVID-19 vaccine safety update 2021. Available from: https://www.fda.gov/media/146269/download.


This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Journal of Clinical Gynecology and Obstetrics is published by Elmer Press Inc.

 

Browse  Journals  

     

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Clinical Gynecology and Obstetrics, quarterly, ISSN 1927-1271 (print), 1927-128X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal, the authors retain the copyright, the journal is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International
License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jcgo.org   editorial contact: editor@jcgo.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.