How COVID-19 affect pregnant women?
4/23/2020 3:24:26 PM
Pregnant women are more likely to get respiratory infections caused by viruses. Due to physiological changes in the immune system, circulatory and respiratory systems, pregnant women are more susceptible to severe illness from respiratory viral infection. According to 2009 statistics, they accounted for 1% of patients who were infected by virus A but up to 5% of all influenza-related deaths. Besides, SARS-CoV & MERS-CoV caused serious complications during pregnancy including kidney failure and death. The mortality rate in pregnant women infected with SARS-CoV was up to 25%.
Nonetheless, there is no evidence until now showing that pregnant women are more susceptible to COVID-19 infection or more severe pneumonia when infected. The clinical features also differ like lymphopenia. Case series summary data of 56 pregnant women diagnosed with COVID-19 showed that the most common symptoms are fever and cough.; two-third of patients had leukopenia and increased C-reactive protein (CRP), 83% cases taken chest CT showed multifocal translucent glass lesions. Concerns about the effect of COVID-19 to fetus and infant are greater than the infectious effects of the disease. Thus, pay attention to pregnancy prevention, diagnosis, and management.
Fever is a common symptom of COVID-19 patients. Maternal fever in early pregnancy can cause congenital abnormalities in the neural tube, heart, kidneys, and other organs. However, a recent study of 80.321 pregnant women showed that the rate of fever in early pregnancy was 10%, the rate of fetal malformations was 3,7. Among 77.344 pregnancies at 16 - 29 weeks, 8321 cases were reported having fevers above 38 degrees C for 1-4 days. Compared with those without fever, the risk of fetal malformations didn’t increase (odds ratio [OR] = 0,99 (KTC 95%, 0,88 - 1,12)).
Based on global data, pregnant women who have pneumonia caused by other viruses (n=1462) have a higher risk of preterm births, fetal growth retardation, and low birth weight, an Apgar score of 5 minutes less than 7 compared to the group without pneumonia (n=7310).
According to a report of 12 pregnant cases infected by COVID-19 in HongKong, China recorded 3 cases of maternal death, 4 out of 7 patients first-trimester miscarriage, 4 out of 5 cases preterm births, 2 cases recovery but then fetal growth retardation. Regarding consequences of pneumonia caused by COVID-19 with neonatal cases analyzed by Chen, all 9 infants had 1 minute Apgar score of 8-9 and 5 minutes of 9-10. Amniotic fluid, cord blood, and throat swabs of infants from six patients with confirmed SARS-CoV-2 infection all were virus-negative indicating that no evidence of vertical transmission in women with COVID-19 in later pregnancy.
Two neonatal cases were reported infected by COVID-19 but it might be postpartum. Another study analyses 38 pregnant women showing similar results with SARS-CoV and MERS-CoV, in no case identified vertical transmission from mother to fetus. All samples tested qRTPCR, including placenta, wear negative with SARS-CoV-2.
Source: FIGO
Advice from Dr. First Degree Specialist Pham Thi Ngoc Tuyet - Department of Obstetrics and Gynecology CarePlus International Clinics
Pregnant women should follow all safety guidances for instance proper nutrition, stay happy, wash hands before eating, avoid crowded places, wear masks when going out or whenever you take a pregnancy check, keep 2 meters away from others. Strong resistance can help you overcome the disease.
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