![]() ![]() The SARS epidemic occurred from November 2002 to July 2003, affecting greater than 8000 persons in 26 countries and resulting in 774 fatalities. 22, 23 This association has also been previously demonstrated to occur when pregnant women develop either of 2 pathogenic coronavirus infections: severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). 22 Outcomes data from multiple studies of influenza have demonstrated an increased risk of maternal morbidity and mortality when compared with nonpregnant women. Changes in the maternal cardiovascular and respiratory systems, including increased heart rate, stroke volume, oxygen consumption, and decreased lung capacity, as well as the development of immunologic adaptations that allow a mother to tolerate an antigenically distinctive fetus, increase the risk for pregnant women to develop severe respiratory disease. The physiologic and immunologic changes that occur as a normal component of pregnancy can have systemic effects that increase the risk for complications from respiratory infections. Pregnancy increases the risk of adverse obstetric and neonatal outcomes from many respiratory viral infections. Analysis of additional cases is necessary to determine if this remains true. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. All neonatal specimens tested, including placentas in some cases, were negative by RT-PCR for SARS-CoV-2. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants, including clinical, laboratory, and virologic data, and the transmissibility of the virus from mother to fetus. This article reviews the effects of 2 previous coronavirus infections-severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV-on pregnancy outcomes. Previous epidemics of many emerging viral infections have typically resulted in poor obstetric outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe, creating a massive public health problem. ![]()
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