Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnancy has been associated with preeclampsia, stillbirth, preterm birth and other adverse outcomes, a new study published in CMAJ (Journal of Canadian Medical Association) .
“Our findings 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 women with severe COVID-19 symptoms have a particularly high risk of these complications,” says Dr. Nathalie Auger, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, with co-authors.
The researchers reviewed 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 a double risk of preterm birth and a 50% increased risk of cesarean delivery in pregnant women with symptomatic COVID-19 than in those with asymptomatic COVID-19. Those with severe COVID-19 had a 4-fold higher risk of high blood pressure and premature birth.
The reason for the increased risk of adverse outcomes is not clear, but it could be because SARS-CoV-2 can lead to vasoconstriction and stimulate an inflammatory response affecting blood vessels.
The findings of this systematic review differ from previous findings from reports and case series. “Our meta-analysis of recent cohort studies of good quality with comparative data does not match previous reviews and provides clear evidence that symptomatic or severe COVID-19 is associated with a significant risk of preeclampsia, preterm birth, and low birth weight,” the authors write.
“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.
“The Impact of COVID-19 on Pregnancy Outcomes: A Systematic Review and Meta-Analysis” was published on March 19, 2021.
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