A review of initial data on pregnancy during the COVID-19 outbreak: implications for assisted reproductive treatments

Abstract

The current outbreak of the novel 2019 coronavirus disease started in China in December 2019 and has since spread to several other countries. On March 25, 2020, a total of 375,498 cases had been confirmed globally with 2,201 cases in Brazil, showing the urgency of reacting to this international public health emergency. While in most cases, mild symptoms are observed, in some cases the infection leads to serious pulmonary disease. As a result, the possible consequences of the COVID-19 outbreak for pregnant women and its potential effects on the management of assisted reproductive treatments, demand attention. In this review, we summarize the latest research progress related to COVID-19 epidemiology and the reported data of pregnant women, and discuss the current evidence of COVID-19 infections during pregnancy and its potential consequences for assisted reproductive treatments. Reported data suggest that symptoms in pregnant women are similar to those in other people, and that there is no evidence for higher maternal or fetal risks. However, considering the initial data and lack of comprehensive knowledge on the pathogenesis of SARS-CoV-2 during pregnancy, human reproduction societies have recommended postponing the embryo transfers and do not initiate new treatment cycles. New evidence must be considered carefully in order to adjust these recommendations accordingly at any time and to guide assisted reproductive treatments.

Emotional Eating in Pregnant Women during the COVID-19 Pandemic and Its Association with Dietary Intake and Gestational Weight Gain

“…Reproductive health is a significant public health issue during pandemics [4]; however, there is a limited amount of information on how the novel coronavirus affects pregnant women. Although several studies indicated that pregnant women are no more likely to be at a higher risk of becoming seriously ill from COVID-19 [5], a previous study revealed women experience changes in their bodies that may increase the risk of other illnesses, such as viral respiratory infections [6]. This uncertainty is feeding many pregnant women's anxiety.…”

Potential COVID-19 Effects on Reproductive Systems and Fertility; ART Guidelines and Considerations: A Review

“…50 Infection control guidelines in ART centres and laboratories Table 2 below lists recommendation for infection control in ART centres and laboratories to help reduce risk of COVID-19 spreading during procedures. 44,45,[50][51][52][53][54] As SARS-CoV-2 can be present in semen, strict protective protocols should be implemented in handling these specimens. 55 Extreme care should be taken during sperm cryobanking, and samples should be stored in highly secured segregated cryovessels.…”

“…While there is no clear evidence supporting vertical transmission, it cannot be ruled out due to COVID-positive placental and fetal membranes and neonates being tested positive after birth. 12,27,50,52,[57][58][59] Immunosuppression and hormonal fluctuation during pregnancy leave women more vulnerable to respiratory pathogens and severe pneumonia. 52 Nevertheless, there is no evidence stating increased susceptibility of COVID-19 in pregnancy.…”

“…44 Pregnant women with COVID-19 also do not have symptoms more severe than non-pregnant women. 52,57,60 Although the exact pathogenesis of COVID-19 in pregnancy is unclear, pregnancy with COVID-19 is associated with more maternal and fetal complications. 52 These adverse pregnancy outcomes include preterm birth (most common), fetal distress, IUGR, increase caesarian sections, miscarriages, fetal, neonatal and maternal deaths.…”

Management of ART and COVID-19: Infertility in Times of Pandemic. What Now?

“…From then on, the infection due to the new Coronavirus, called COVID-19, was officially an international emergency (WHO, 2020a). On March 11, 2020, the situation escalated even more, as WHO declared that COVID-19 became pandemic due to its global geographical distribution (Monteleone et al, 2020).…”