COVID-19 in pregnancy associated with preeclampsia, stillbirth, prematurity

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy is associated with preeclampsia, stillbirth, prematurity and other adverse outcomes, new research published in CMAJ (Journal of the Canadian Medical Association) .

“Our results suggest that pregnant women with COVID-19 have an increased risk of high blood pressure, stillbirth and premature birth. Their newborns are more likely to need intensive care. Pregnant people with severe symptoms of COVID-19 have a particularly high risk of these diseases. complications, ”explains Dr. Nathalie Auger, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, with co-authors.

Researchers looked at 42 studies involving 438,548 pregnant women from around the world to determine the association between SARS-CoV-2 infection and adverse pregnancy outcomes. They found double the risk of premature birth and a 50% increased risk of cesarean delivery in pregnant women with symptomatic COVID-19 than in those with asymptomatic COVID-19. People with severe COVID-19 had a 4 times higher risk of high blood pressure and preterm labor.

The reason for the increased risk of side effects is unclear, but could be because SARS-CoV-2 can cause vasoconstriction and stimulate an inflammatory response affecting blood vessels.

The results of this systematic review differ from previous results from case reports and case series. “Our meta-analysis of recent good-quality cohort studies with comparative data does not match these previous reviews, and provides clear evidence that symptomatic or severe COVID-19 is associated with a considerable risk of preeclampsia, preterm birth and low birth weight, “write the authors.

“Clinicians should be aware of these adverse outcomes when managing pregnancies affected by COVID-19 and adopt effective strategies to prevent or reduce risks to patients and fetuses,” they conclude.