Functional consequences of SARS-CoV-2 infection in pregnant women, fetoplacental unit, and neonate

The SARS-CoV-2 infection causes COVID-19 disease, characterized by acute respiratory distress syndrome, bilateral pneumonia, and organ failure. The consequences of maternal SARS-CoV-2 infection for the pregnant woman, fetus, and neonate are controversial. Thus, it is required to determine whether there is viral and non -viral vertical transmission in COVID-19. The disease caused by SARS-CoV-2 leads to functional alterations in asymptomatic and symptomatic pregnant women, the fetoplacental unit and the neonate. Several diseases of pregnancy, including COVID-19, affect the fetoplacental function, which causes in utero programming for young and adult diseases. A generalized inflammatory state and a higher risk of infection are seen in pregnant women with COVID-19. Obesity, diabetes mellitus, and hypertension may increase the vulnerability of pregnant women to infection by SARS-CoV-2. Alpha, Delta, and Omicron variants of SARS-CoV-2 show specific mutations that seem to increase the capacity of the virus to infect the pregnant woman, likely due to increasing its interaction via the virus S protein and angiotensin-converting enzyme 2 receptors. This review shows the literature addressing to what extent COVID-19 in pregnancy affects the pregnant woman, fetoplacental unit, and neonate. Prospective studies that are key in managing SARS-CoV-2 infection in pregnancy are discussed.

Automated summary

The SARS-CoV-2 infection causes COVID-19 disease, which leads to acute respiratory distress syndrome, bilateral pneumonia, and organ failure. The effects of maternal SARS-CoV-2 infection on pregnant women, fetuses, and neonates are still controversial, and it is important to determine the presence of viral and non-viral vertical transmission. SARS-CoV-2 infection alters the function of asymptomatic and symptomatic pregnant women, the fetoplacental unit, and the neonate, and various pregnancy-related diseases, including COVID-19, can affect the fetoplacental function and result in long-term health consequences.