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Licensed Unlicensed Requires Authentication Published by De Gruyter February 11, 2021

COVID-19 and pregnancy: are they friends or enemies?

  • Tamara Gulic ORCID logo and Gordana Blagojevic Zagorac ORCID logo

Abstract

Objectives

Novel coronavirus disease (COVID-19) is rapidly spreading all over the world. Although in many cases the infection causes very weak symptoms, it can be severe in patient with diverse chronical diseases and immunological compromising patients. Pregnancy is a unique condition in which mother and fetus peacefully collaborate. Diverse endocrine-immune mechanisms, mostly under progesterone control work together to protect the fetus from maternal immunocompetent cell activation driven rejection. The physiological shift to Th2 dominant environment, while favourable for fetus, it makes mothers susceptible to infective pathogens, making pregnancy during COVID-19 pandemic challenging.

Materials and methods

Studies involving COVID-19 in pregnancy and those analysing changes of immune system induced by COVID-19 were searched in databases such as PubMed, Scopus, Google Scholar and ScienceDirect. Databases were searched using a keyword COVID-19/coronavirus, that was combined with following terms: immune system, pregnancy, oestrogen, or progesterone. Search included studies published up to 01.07.2020. Almost 1,500 articles were found, but only 18 met criteria.

Results

Most frequent symptoms of COVID-19 in mothers infected in the late pregnancy were fever and cough accompanied with lymphopenia and elevated C-reactive protein. Mothers reported to have severe disease had comorbidities and were obese. Low rate of neonatal complications of maternal Sars-Coc-2 infection without neonatal mortality was observed.

Conclusions

Currently available data didn’t show significant relationship between COVID-19 severity and pregnancy and there is no strong evidence that mother’s infection can lead to adverse pregnancy outcome, but further studies are needed to determinate the possible effects of COVID-19 gained during earlier pregnancy.


Corresponding author: Gordana Blagojevic Zagorac, Department of Physiology and Immunology, School of Medicine, University of Rijeka, Rijeka, Croatia; and University North – University Center Varaždin, Varaždin, Croatia, Phone: +385 51 651 186, E-mail:
Tamara Gulic and Gordana Blagojevic Zagorac contributed equally to this work.

Funding source: Tamara Gulic

Award Identifier / Grant number: uniri-pr-biomed-19-171498

Funding source: Gordana Blagojevic Zagorac

Award Identifier / Grant number: Grants uniri-biomed-18-229-1392

Acknowledgement

The authors are grateful for support given by University of Rijeka.

  1. Research funding: The investigation was supported by grants from the University of Rijeka (Grants uniri- - biomed- 18-229-1392 to GBZ, uniri-pr-biomed-19-171498 to TG).

  2. Author contributions: Conceptualization, GBZ, TG; investigation, GBZ, TG; data curation, TG, GBZ; writing—original draft preparation GBZ, TG; writing—review and editing, GBZ, TG; supervision GBZ. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: The authors have no conflicts of interest to declare.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2020-07-30
Accepted: 2021-01-25
Published Online: 2021-02-11

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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