Pathophysiology of COVID-19 in Pregnancy: A Critical Review

Abstract

COVID-19 infection during pregnancy presents a complex clinical scenario with potential implications for both maternal and neonatal health. This literature review examines the pathophysiological mechanisms underlying COVID-19 in pregnancy and its effects on the developing foetus and neonate. The infection is known to impact placenta, potentially leading to abnormalities in foetal development. Maternal immune responses, including cytokine storm and endothelial activation, contribute to the systemic inflammation observed in severe cases, which may result in adverse pregnancy outcomes such as preterm birth, preeclampsia and fetal growth restriction. Additionally, there is a risk of vertical transmission of the infection, although it appears to be rare. Neonates born to mothers with COVID-19 may experience respiratory complications and require NICU admission. Furthermore, the long-term consequences of COVID-19 infection during pregnancy on neonatal health and development, including the risk of multisystem inflammatory syndrome in child, are areas of ongoing research and requires further investigation. Understanding pathophysiology of these conditions during pregnancy is crucial for developing effective management strategies and improving maternal and neonatal outcomes. Present literature review aims to provide a comprehensive overview of the reported pathophysiological mechanisms of COVID-19 infection in pregnant women and their foetus, highlighting the need for continued research and surveillance to address the gaps in knowledge and inform clinical practice.