SARS-CoV-2 in Pregnancy: Fitting Into the Existing Viral Repertoire

Abstract

The risk of viral infection during pregnancy is well-documented; however, the intervention modalities that in practice enable maternal-fetal protection are restricted by limited understanding. This becomes all the more challenging during pandemics. During many different epidemic and pandemic viral outbreaks, worse outcomes (fetal abnormalities, mortality, preterm labor, etc.) seem to affect pregnant women than what has been evident when compared to non-pregnant women. The condition of pregnancy, which is widely understood as “immunosuppressed,” needs to be re-understood in terms of the way the immune system works during such a state. The immune system gets transformed to accommodate and facilitate fetal growth. The interference of such supportive conversion by viral infection and the risk of co-infection lead to adverse fetal outcomes. Hence, it is crucial to understand the risk and impact of potent viral infections likely to be encountered during pregnancy. In the present article, we review the effects imposed by previously established and recently emerging/re-emerging viral infections on maternal and fetal health. Such understanding is important in devising strategies for better preparedness and knowing the treatment options available to mitigate the relevant adverse outcomes.

Characterization of extracellular vesicles in COVID-19 infection during pregnancy

“…Later studies have shown that the majority of pregnant women experience mild disease ( Overton et al, 2022 ). Although SARS-CoV-2 infection during pregnancy is associated with a modest increase in risk of morbidity and pregnancy related complications ( Ciapponi et al, 2021 ; Rajput and Sharma, 2021 ; Male, 2022 ), these complications are mostly restricted to patients with severe disease ( Rajput and Sharma, 2021 ; Male, 2022 ). These patients are at increased risk of cesarean delivery and preterm birth ( Marchand et al, 2022 ), and the risk increases further in those with severe disease and pre-existing risk factors such as older age, obesity and gestational diabetes ( Conde-Agudelo and Romero, 2022 ).…”