Severity of COVID‐19 in pregnancy: A review of current evidence

Kucirka, Lauren M.; Norton, Alexandra; Sheffield, Jeanne S.

doi:10.1111/aji.13332

Cited by 51 publications

(66 citation statements)

References 57 publications

(118 reference statements)

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“…Research shows that in different populations, the clinical spectrum of COVID‐19 can be varied and may be affected by several factors, including underlying conditions, such as diabetes, hypertension, heart disease, chronic lung disease, and cancer. History of underlying diseases are disproportionately affected by COVID‐19 and are at higher risk of severe disease and death 5–7 . Pregnancy is also considered a risk factor for severe pneumonia due to its unique “immunological” conditions and physiological cardiopulmonary changes (diaphragm elevation, increased consumption of oxygen, and respiratory tract mucosal edema) 8 .…”

Section: Introductionmentioning

confidence: 99%

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The severity of COVID‐19 among pregnant women and the risk of adverse maternal outcomes

Samadi

Alipour

Ghaedrahmati³

et al. 2021

Intl J Gynecology & Obste

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Objective To evaluate the relationship between the severity of coronavirus disease 2019 (COVID‐19) during pregnancy and the risk of adverse maternal outcomes. Methods A descriptive‐analytical cross‐sectional study conducted on 258 pregnant women who were hospitalized due to confirmed COVID‐19 from March 2020 to January 2021 at the Forghani Hospital in Qom, Iran. Demographic and obstetric characteristics, laboratory findings, and adverse maternal outcomes were recorded from the patients’ medical records. The Fisher exact test, one‐way analysis of variance, and regression logistics were used to assess the relationship between variables. Results Of the total study population, 206 (79.8%) pregnant women had mild to moderate disease, 43 (16.7%) had severe disease, and 9 (3.5%) were in the critical stage of the disease. Eight women (3.1%) died and 33 (12.8%) were admitted to the intensive care unit (ICU). The most important demographic factors associated with the severity of the disease were ethnicity, underlying conditions, maternal age, and parity. The severity of the disease was significantly associated with increased cesarean delivery and admission to the ICU. Conclusion Pregnant women with severe and critical disease had a high rate of cesarean delivery and admission to the ICU. There were eight cases of maternal mortality.

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Section: Introductionmentioning

confidence: 99%

“…History of underlying diseases are disproportionately affected by COVID-19 and are at higher risk of severe disease and death. [5][6][7] Pregnancy is also considered a risk factor for severe pneumonia due to its unique "immunological" conditions…”

mentioning

confidence: 99%

The severity of COVID‐19 among pregnant women and the risk of adverse maternal outcomes

Samadi

Alipour

Ghaedrahmati³

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…The maternal disease severity was classified as mild, moderate, or severe according to the clinical presentations of the mother as defined by Kucirka et al 4 ►Table 1 shows the classification system of maternal disease severity.…”

Section: Methodsmentioning

confidence: 99%

Severity of Maternal SARS-CoV-2 Infection in Pregnancy Predicts Neonatal Outcomes

et al. 2021

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Objective The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak had an enormous global impact. Pregnant women with SARS-CoV-2 appear to have higher morbidity and mortality. This study aimed to evaluate the effect of the severity of maternal SARS-CoV-2 infection on neonatal outcomes. Study Design The clinical and laboratory data of 40 women and neonates evaluated retrospectively. Results This retrospective study showed that SARS-CoV-2 infection had an adverse impact on neonatal outcomes proportionally with the maternal disease severity including increased prematurity rates, postnatal resuscitation need, prolonged hospital stay and longer ventilatory support requirement in infants born to mothers with moderate or severe disease. Conclusion Maternal disease severity had adverse effects on neonatal outcomes. The severity of maternal disease was found to be associated with increased rates of prematurity, requirement of postnatal resuscitation, prolonged hospital stay, and longer ventilatory support. Key Points

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“…Because evidence that pregnancy is a risk factor for severe COVID-19 disease comes primarily from HIC 7,[12][13][14][15][16] , regulatory bodies in LMIC face an additional challenge. Additional vaccine data on the safety and efficacy in pregnancy will likely strengthen regulators' positions in low-resource settings to make timely and clear recommendations on the vaccine use in pregnancy and avoid unfair delays or denials of vaccine access to pregnant frontline workers in these contexts.…”

Section: Avoid Delays In Pregnancy-specific Data For Covid-19 Vaccines Currently In Developmentmentioning

confidence: 99%

Global equity in protection of pregnant frontline workers

et al. 2021

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Vaccination of frontline workers against COVID-19 is underway in some countries. With women comprising a majority of health, education, and other essential workforces, many on the front lines of the pandemic response will be pregnant at the time that they are offered COVID-19 vaccines. However, pregnant people were not included in any of the COVID-19 vaccine trials that regulatory agencies evaluated when considering authorization. Without pregnancy-specific data, pregnant frontline workers in some settings are being denied COVID-19 vaccines. In other settings, pregnant frontline workers are able to access these same vaccines, but are faced with the burden of decision-making in the absence of an explicit recommendation for use and without pregnancy-specific data. While permissive recommendations for use in pregnancy are ethically preferable to unjustly denying vaccine access, objectives to protect the frontline workforce will fall short until there is evidence to support explicit recommendations for COVID-19 vaccination in pregnancy. In this article, we provide three actionable recommendations to ensure equitable protection of pregnant frontline workers as vaccines against COVID-19 continue to be developed and rolled out globally. First, efforts must be taken now to leverage critical opportunities for narrowing the evidence gaps around currently authorized COVID-19 vaccines in pregnancy. Next, action in the near term is needed to preempt evidence gaps for COVID-19 vaccines still in development. Finally, in the absence of an explicit recommendation for use in pregnancy, and while pregnancy-specific data lags behind, pregnant people should be prioritized for alternate preventive and treatment measures. Achieving equitable protection for those who are pregnant and serving on the frontlines of the pandemic will require no less.

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Severity of COVID‐19 in pregnancy: A review of current evidence

Cited by 51 publications

References 57 publications

The severity of COVID‐19 among pregnant women and the risk of adverse maternal outcomes

The severity of COVID‐19 among pregnant women and the risk of adverse maternal outcomes

Severity of Maternal SARS-CoV-2 Infection in Pregnancy Predicts Neonatal Outcomes

Global equity in protection of pregnant frontline workers

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