Two medical students at Weill Cornell Medicine-Qatar (WCM-Q) conducted a systematic review of the latest medical literature to provide a clearer understanding of how the novel coronavirus affects pregnant women, new mothers and newborn babies.
Second-year students Reem Chamseddine and Farah Wahbeh reviewed 245 pregnancies that were complicated by maternal SARS-CoV-2 infection across 48 scientific studies published between the emergence of the pandemic in December 2019 and 30 July 2020. They found that 55.9% of pregnant women with SARS-CoV-2 infection presented with fever and 36.3% with a cough. A total of 12.7% presented with shortness of breath, but only 4.1% developed respiratory distress.
The vast majority – 89% – of the pregnant women with SARS-CoV-2 delivered their babies via cesarean section, compared with 15% in the general population, the study noted.
Out of 201 newborns reported in the literature, 35.3% of babies born to mothers with SARS-CoV-2 were delivered pre-term (before 36 weeks), compared with 13% in the general population. There was a concerning 2.5% rate of stillbirth delivery or neonatal death, compared with less than 1% in the general population.
However, the study indicated that the risk of death for pregnant women with SARS-CoV-2 is low, and that it does not appear that the infection is vertically transmitted from mother to fetus during pregnancy, although 6.45% of newborns tested positive for the disease. It is possible these newborns acquired SARS-CoV-2 infection in the hospital or at home after birth, according to the literature.
The study also found that SARS-CoV-2 does not appear to be passed from mother to baby in breast milk, but that there is still a risk the infection can be passed on via respiratory droplets during breastfeeding. As such, SARS-CoV-2-positive mothers are advised to take reasonable precautions during breastfeeding.
The study titled, Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection: A Systematic Review, was published in the Journal of Pregnancy, a leading peer-reviewed open-access journal.
Reem Chamseddine, a member of WCM-Q Class of 2023, said that in the early days of the pandemic, not much was known regarding pregnancy complications in the setting of SARS-CoV-2 infection. Naturally, it was important, she said, to understand the emerging data about this topic as the virus would affect thousands of pregnant women.
As medical students, we are encouraged to be curious and to engage in the healthcare issues around us. Getting to work on this project is an example of the academic values instilled in us here at WCM-Q.
Farah Wahbeh, also a member of the Class of 2023, said that their role as medical student does not stop at learning how to diagnose and treat medical conditions.
It is also our responsibility to take action during such uncertain times and to contribute in every way we can. This experience has been unique, given the urgency and time sensitivity associated with the project. It taught us valuable skills and embodied our role as active contributors to the scientific community.
Reem and Farah were mentored by Dr Arash Rafii Tabrizi during the research process. Dr Tabrizi is a professor of Genetic Medicine in Obstetrics and Gynecology at WCM-Q, and is also named author of the research paper.
The work was difficult, according to Dr Tabrizi, as new information were coming in almost every day, and Reem and Farah had to filter and organise it correctly. The final result is a great review that really illustrates the impact of COVID-19 on pregnant women as well as their newborn babies.
The review can be read in full through this LINK.