COVID-19 and pregnancy: What we know about what happens to i
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Any new infectious disease poses unique challenges to people who are pregnant during an outbreak. The effects of SARS, Zika and influenza in pregnancy highlight the potential immediate and longer term detrimental health outcomes a virus can have for both mother and baby. These risks include premature delivery of the baby with SARS, birth defects with Zika and greater risk of severe influenza. Should we be as worried about pregnancy and COVID-19 There are a number of things we need to think about. These fall into two broad areas related to the effects on the fetus and the effects on the pregnant person themselves.

In both cases we need to think about the immediate effects during the pregnancy as well as the longer-term health effects for both parent and child. The early evidence we have shows that changes to the immune system during pregnancy could be somewhat protective against the disease. Early data from pregnant women with COVID-19 indicates that the disease is linked to premature birth and changes to the placenta that might reflect altered blood flow. This suggests that virus-associated disruptions do occur between parent and fetus.

However, these studies were of women with severe cases of the disease. We know very little about the effect of mild disease or asymptomatic infection in pregnancy. Understanding this is critical, as studies have highlighted that asymptomatic and mildly infected pregnant woman far outnumber those requiring hospitalization for COVID-19. This indicates that pregnant people are not more susceptible to severe COVID-19, which was one of the greatest concerns at the beginning of the pandemic and led to them being categorized as vulnerable. The apparent protective effect of pregnancy against severe disease might simply reflect the different immune responses to severe COVID-19 seen in men and women and the fact that more men than women die from the disease in general. However, we do not see the same response in pregnancy with other viruses, such as influenza, suggesting something else is at play with SARS-CoV-2.