Impact of COVID-19 on pregnancy and delivery — current knowledge

Abstract

The World Health Organization announced on 12 March 2020 a global pandemic of the new SARS-CoV-2 coronavirus causing COVID-19 disease associated with pneumonia and acute respiratory failure. SARS-CoV-2 has caused so far over 6.66 million recorded cases, of which 393,000 ended in death (as of June 1, 2020). Despite the demographic statistics of incidence, there is no current recording of cases in the group of pregnant or perinatal women. Changes occurring in the female body system during pregnancy also affect and alter the immune system, and as studies based on other viral respiratory infections have shown, the population of pregnant women is at risk of having a severe course of the disease. The aim of the study is to summarize current reports on the course of COVID-19 disease in a group of pregnant women and the possible impact of SARS-CoV-2 on the foetus and vertical transmission, taking into account changes occurring in the woman's immune system during pregnancy. Available advice and recommendations for antenatal and perinatal care of pregnant women during the pandemic period are also included.

Fear, anxiety and depression among pregnant women during COVID-19 pandemic: impacts of healthy eating behaviour and health literacy

“…Moreover, the reduction of the innate immune responses in pregnant women increased maternal susceptibility to COVID-19 infection that involved high maternal mortality [ 61 , 62 ], which may lead to maternal anxiety and depression symptoms. In addition, pregnant women faced many difficulties during the COVID-19 pandemic, such as limitation in assessing healthcare services [ 5 ] and the chance of infection during delivery and hospital visits [ 63 ], especially the high risk of delivery in the late pregnancy, which may increase the possibility of anxiety and depression.…”

Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being

“…Available recommendations regarding the week of delivery in women with confirmed or suspected COVID-19 infection are limited. Only five publications recommended considering delaying the delivery date, but only if maternal and fetal conditions permitted [ 25 , 27 , 45 , 47 , 49 ]. On the other hand, only one publication indicated that COVID-19 is not an indication for preterm delivery [ 50 ].…”

“…The remaining recommendations, 6 made at the non-country specific level [ 25 , 26 , 36 , 38 , 39 , 56 ] and 11 at the national level [ 29 , 30 , 42 , 44 , 45 , 47 , 48 , 52 , 53 , 57 , 58 ], allowed for family births with 1 person arranged by the mother. Making the possibility of family birth dependent on local conditions and leaving the final decision to the authorities of each hospital were included in four papers, one on the non-country specific level [ 49 ] and three on the national level [ 23 , 24 , 53 ]. Moreover, one paper recommended no visitors or one support person [ 59 ].…”

“…Five of the publications [ 39 , 55 , 56 , 68 , 69 ] suggested prohibiting visits only when a child or the mother was suspected of SARS-CoV-2 infection or was already diagnosed with COVID-19. Moreover, three other papers recommended visits only when the mother’s illness did not allow her to take care of the newborn [ 49 , 50 , 66 ]. When visits were allowed, the authors recommended additional specific requirements.…”

“…In seven articles, we found further conditions to be met by visitors, mainly related to the degree of relationship to the mother [ 25 , 28 , 49 , 60 , 61 , 65 , 67 ], the majority of which were published no later than October 2020. Four [ 49 , 60 , 61 , 67 ] limited visits to family members, not indicating the exact relationship with the mother, two recommended the father only [ 28 , 65 ], and one restricted visitors to people living in the same household [ 25 ]. Five publications [ 25 , 28 , 30 , 58 , 68 ] included requirements on visitors’ age.…”