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Mother to Newborn Transmission of SARS-CoV-2 Infection: Evolution of Evidence in 1.5 Years of COVID-19 Pandemic

Journal

AMERICAN JOURNAL OF PERINATOLOGY
Volume 39, Issue 16, Pages 1764-1778

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0042-1749635

Keywords

COVID-19; SARS-CoV-2; pregnancy; newborn; vaccination

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The COVID-19 pandemic has had a significant impact on mortality and morbidity globally. Guidelines for caring for pregnant women and newborns have evolved rapidly due to uncertainties surrounding transmission and the effects of COVID-19. Evidence suggests that pregnant women with symptomatic COVID-19 are at increased risk of severe illness and premature deliveries, while babies born to infected mothers may require intensive care. Vaccination during pregnancy is strongly recommended to reduce maternal morbidities and provide antibodies to newborns. Racial, ethnic, and socioeconomic disparities in outcomes and vaccination coverage exist for pregnant women.
Coronavirus disease 2019 (COVID-19) pandemic caused significant mortality and morbidity in people of all age groups worldwide. Given the uncertainty regarding the mode of transmission and potential effects of COVID-19 on pregnant mothers and their newborns, guidelines for taking care of maternal-newborn dyads have evolved tremendously since the pandemic began. There has been an enormous influx of published materials regarding the outcomes of mothers and newborns. Still, multiple knowledge gaps regarding comprehensive information about risk to the mothers and newborns exist, which need to be addressed. Current evidence suggests that mothers with symptomatic COVID-19 infection are at increased risk of severe illness during pregnancy, with a higher need for respiratory support and premature deliveries. Neonates born to mothers with COVID-19 are at increased risk of needing intensive care; however, most newborns do well after birth. As new mutant variants arise, we need to be cautious while proactively understanding any new evolving patterns. All leading health authorities strongly recommend COVID-19 vaccination before or during pregnancy to reduce the risk of maternal morbidities and benefit from passing antibodies to newborns prenatally and via breastmilk. Additionally, there are racial, ethnic, and socioeconomic disparities in outcomes and vaccination coverage for pregnant women. This article summarizes the rapidly evolving evidence for the last 1.5 years and aims to help health care professionals care for mothers with COVID-19 and their newborns.

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