Adverse Pregnancy Outcomes (Maternal, Fetal, and Neonatal) in COVID-19: A Review

Abstract

Pregnant women represent a vulnerable population due to their altered immune response, potentially leading to increased susceptibility and severity of infections. The COVID-19 infection might increase the risk of adverse pregnancy outcomes in this population, however, to date, it has not been established whether SARS-CoV-2 infection leads to these outcomes as differing conclusions have been made by the published studies and reviews. This comprehensive review explores the impact of COVID-19 on pregnancy outcomes, encompassing maternal, fetal, and neonatal health. The current literature reports higher rates of adverse maternal outcomes among pregnant women with COVID-19, this includes increased rates of cesarean section, preeclampsia, and elevated risk of intensive care unit (ICU) admission and maternal death. Fetal and neonatal outcomes are also influenced by COVID-19 infection during pregnancy. Findings suggest an elevated risk of preterm birth, low birth weight, stillbirth, and Neonatal ICU admissions among newborns of mothers with COVID-19. The emergence of SARS-CoV-2 variants, such as the Delta variant, raises concerns about their potential impact on more adverse outcomes compared to the wild type. Vaccination has demonstrated safety and efficacy in pregnant women, providing a potential preventive measure against COVID-19. However, the potential impact of vaccination on adverse pregnancy outcomes requires further investigation. To address current knowledge gaps, future research should also focus on long-term effects, fertility considerations, child development, and the impact of emerging variants.