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Pregnancy is a special period in a woman’s life. At this time, the immune system of the expectant mother weakens and becomes more susceptible to respiratory viral diseases. During influenza epidemics, pregnant women are at increased risk. Many expectant mothers require hospitalization. Infection with a viral disease increases the risk of miscarriage, stillbirth. In addition, viral diseases transferred during pregnancy increase the risk of having a baby with a cleft lip, heart disease, and spina bifida. [1].
All this is not news either for doctors or expectant mothers. But over the past year, humanity has encountered a new virus – SARS-CoV-2, about which little is known so far. Including scientists and doctors have very little information about how the causative agent of COVID-19 and the disease transferred during pregnancy affect the condition of the woman and the fetus. The results of the first large-scale studies are just beginning to emerge. But even this information is still too little to draw categorical conclusions.
Why is COVID-19 dangerous for a pregnant woman?
The first danger of COVID-19 for expectant mothers lies in the fact that their immune system primarily works to protect the fetus, which makes the woman herself more vulnerable to viruses. But at the same time, a powerful immune response can cause a complication of a woman’s condition.
The SARS-CoV-2 virus primarily attacks the lungs and cardiovascular system, which are already under increased stress in pregnant women. As the fetus develops, there is less room for the lungs in the chest cavity. Because of this, pregnant women often suffer from shortness of breath and impaired lung function.
For the proper development of the fetus, a pregnant woman needs a large amount of oxygen, which is why the volume of blood in the body of the expectant mother increases significantly. All this puts an increased strain on the woman’s heart, which must work harder to keep the two bodies circulating. If COVID-19 infection occurs at this time, the workload on the heart increases even more.
Another potential hazard for a pregnant woman with COVID-19 is the fluid in her body. When the coronavirus disease develops complications, water accumulates in the lungs. There is a lot of it in the body of a pregnant woman, and there is a risk that some of this fluid will end up in the lungs.
In recent studies, it was found that the coronavirus “burns” the lungs, due to an increase in blood clotting in the vessels of the organ. As for pregnant women, they already have higher clotting rates than other people, which increases the risk even more [2]. But fortunately, in practice, complications in pregnant women rarely occur. Although the media reported several cases of death of pregnant women as a result of coronavirus [3] [4].
How does a mother’s disease affect the baby?
Doctors know many cases when a viral disease of the mother can cause disturbances in the development of the fetus. Examples are rubella, cytomegalovirus, Zika fever. Fortunately, there is no such relationship with the coronavirus.
The case of infection of a newborn was recorded in the summer of 2020 [5], but at what stage the infection occurred is not known exactly. Moreover, thousands of other cases confirm that mothers with COVID-19 give birth to healthy children. The virus is not detected either in amniotic fluid or cord blood.
But still, New York doctors found confirmation that for the fetus, infection with the mother’s coronavirus does not go unnoticed. In 14 of the 29 women studied, clots were found on the maternal part of the placenta in the vessels. Because of them, the amount of oxygen and nutrients that the fetus should receive was sharply limited. Therefore, according to researchers, it is extremely important to monitor the development of the child in the second half of pregnancy. [2].
What British researchers found
In September 2020, the results of a study were published in the medical journal BMJ, during which a group of scientists analyzed how COVID-19 affects pregnant women and newborns. It was the first large-scale study of its kind since the start of the pandemic. The study was led by scientists from the University of Birmingham and WHO representatives. According to scientists, pregnant women admitted to the hospital with suspected COVID-19 were less likely to suffer from fever and muscle pain. But in the event of a complication, mothers-to-be are more likely than non-pregnant women with coronavirus disease to require intensive care.
In addition, during the study, scientists found evidence that the presence of chronic diseases, such as diabetes or hypertension, makes pregnant women (as is the case with everyone else) at risk for more severe COVID-19.
The researchers found another pattern. Among pregnant women with coronavirus disease, the percentage of preterm births is higher than among healthy women. In addition, according to the data received, every fourth baby born to an infected mother requires hospitalization in the neonatal unit due to premature birth. At the same time, rates of stillbirth or death among newborns, according to researchers, remain low. [6].
However, it is worth noting that the main cause of preterm birth is not pregnancy complications, but problems with the mother’s respiratory function: the fetus presses on the lungs affected by the virus, making breathing even more difficult. This leads to early delivery.
What did American scientists discover?
American scientists also conducted their own study on the impact of COVID-19 on the body of pregnant women. In particular, experts from the University of California came to an interesting conclusion. Despite the fact that the majority of symptoms of coronavirus infection disappear within a month, in almost a quarter of pregnant women, symptoms can persist for much longer – 2 or more months.
Scientists studied 594 women who were infected with SARS-CoV-2 during pregnancy and found that the most common early symptoms of COVID-19 were:
- cough;
- a sore throat;
- aches in the body;
- fever.
In half of the observed women, symptoms persisted for 3 weeks. And another quarter – lasted 8 weeks [7].
These data refer exclusively to hospitalized patients. But besides this, California scientists launched the PRIORITY project, the purpose of which is to track the health status of outpatient pregnant women. [1].
After studying the symptoms in expectant mothers infected with SARS-CoV-2, scientists systematized the data and got the following results:
- the most common first symptoms of COVID-19 in pregnant women: cough (20%), sore throat (16%), body aches (12%), fever (12%); interestingly, in non-pregnant women with COVID-19, fever is diagnosed in 43% of cases;
- only 6% of expectant mothers lose their sense of smell and taste;
- after 4 weeks, in 60% of women, the symptoms of the disease disappeared, but in 25% it lasted up to 8 weeks or longer;
- 37 days is the average duration of symptoms of the disease in pregnant women.
Other symptoms of COVID-19 diagnosed in pregnant women included:
- dyspnea;
- coryza;
- nausea;
- sneezing;
- vomiting;
- diarrhea;
- dizziness [7].
But in most cases, we can say that coronavirus disease in expectant mothers goes away without serious complications. And if such things happen, then this is rather an exception to the rule. Although it is still too early to draw final conclusions. Research is ongoing, as is monitoring of SARS-CoV-2 infected pregnant women and women who have already given birth and their babies.
- Sources of
- ↑ ↑ University of California San Francisco. – About Priority.
- ↑ ↑ AAAS, By Meredith Wadman, August 4, 2020. – Why pregnant women face special risks from COVID-19.
- ↑ Rossiyskaya Gazeta, December 7, 2020. – In Kolyma, a pregnant woman died of COVID-19.
- ↑ 9tv, November 30, 2020. – An entire family died from the coronavirus in St. Petersburg.
- ↑ Nature, July 14, 2020. – Transplacental transmission of SARS-CoV-2 infection.
- ↑ the BMJ, September 1, 2020. – Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis.
- ↑ ↑ University of California San Francisco, October 7, 2020. – COVID-19 Has a Prolonged Effect for Many During Pregnancy.