Japanese Society for Infection Prevention and Control-Online Journal

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Impact of COVID-19 on Pregnancy and on Fetal and Neonatal Health

Yasumasa YAMADA
Department of Perinatal and Neonatal Medicine, Aichi Medical University Hospital

For a pregnant woman with a confirmed case of COVID-19, there is concern about a perinatal outcome. Two and a half years since the onset of the pandemic, many reports including pregnancy complications and neonatal outcomes have been accumulated. In 2021, several national surveillances (from the UK, Sweden, and Spain) have been published. These reports indicated that the positive rates of polymerase chain reaction (PCR) tests in infants born to mothers tested positive for COVID-19 are supposed to be 1.6%-5%. There is no evidence for intrauterine placental transmissions of COVID-19 to fetuses. Recently, multiple systematic reviews evaluating the impact of COVID-19 on maternal and newborn health have been reported. These reports suggested that pregnant women with COVID-19 have a higher risk of preeclampsia (OR 1.3-1.6) and preterm birth (OR 1.6-1.9) compared with those with no SARS-CoV-2 infection during pregnancy.
Multisystem inflammatory syndrome in children (MIS-C) is an immune-mediated condition occurring weeks after a COVID-19 infection. Multisystem inflammatory syndrome in neonates (MIS-N) presents symptoms consistent with MIS-C related to maternal SARS-CoV-2. It is speculated that transplacental antibodies cause MIS-N. In neonatal patients born to mothers with a history of COVID-19, MIS-N is considered in the differential diagnosis to explain unusual signs of multisystem inflammation.
The current evidence suggests that the risk of newborns acquiring infection during birth hospitalization is low when precautions are consistently taken. Moreover, a viable infectious virus has not been detected yet in breast milk. Recently, it has been recommended globally to avoid separating the mother from the baby. However, in most Japanese hospitals, newborns are still separated from their infected mothers. There is some concern about the negative impact induced by these strict precautions.

Key words：COVID-19, neonates, fetus, SARS-CoV-2, multisystem inflammatory syndrome in children (MIS-C)

e-mail: yamasan＠aichi-med-u.ac.jp

Received: May 6, 2022
Accepted: July 14, 2022

37 (6)：227─234,2022