The Impact of SARS-CoV-2 on Pregnancy The Impact on Black and minority ethnic populations

Main Article Content

Triya Chakravorty

Abstract

Pregnant women are considered a vulnerable group due to the unique immunological changes that take place during pregnancy2. It is important to understand the impact of SARS-CoV-2 on pregnant women and foetuses, in order to produce clinical guidelines for obstetric and neonatal management. In recent months, there has been a rise in research into the impact of SARS-CoV-2 infection on pregnancy.


This essay aims to explore this emerging data and understand the impact of SARS-CoV-2 on pregnancy, including looking at specific sub-populations, such as women from Black and Minority Ethnic (BAME) backgrounds. In addition, it will explore the data surrounding whether vertical transmission from mother to baby is possible. This is an area of considerable controversy.

Article Details

How to Cite
Chakravorty, T. (2020). The Impact of SARS-CoV-2 on Pregnancy: The Impact on Black and minority ethnic populations. Sushruta Journal of Health Policy & Opinion, 14(1), 1-6. https://doi.org/10.38192/14.1.2
Section
Articles
Author Biography

Triya Chakravorty, Queens College, University of Oxford, UK

MBBS Student

References

1 World Health Organisation Coronavirus disease (COVID-19) pandemic, (2020).
2 Mor, G. & Cardenas, I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol 63, 425-433, doi:10.1111/j.1600-0897.2010.00836.x (2010).
3 Mertz, D. et al. Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis. BMC Infect Dis 19, 683, doi:10.1186/s12879-019-4318-3 (2019).
4 Littauer, E. Q. et al. H1N1 influenza virus infection results in adverse pregnancy outcomes by disrupting tissue-specific hormonal regulation. PLOS Pathogens 13, e1006757, doi:10.1371/journal.ppat.1006757 (2017).
5 Wong, S. F. et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 191, 292-297, doi:10.1016/j.ajog.2003.11.019 (2004).
6 Lam, C. M. et al. A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG: An International Journal of Obstetrics & Gynaecology 111, 771-774, doi:10.1111/j.1471-0528.2004.00199.x (2004).
7 Who. (World Health Organization, 2003).
8 Allotey, J. et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 370, m3320, doi:10.1136/bmj.m3320 (2020).
9 Khalil, A. et al. SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. EClinicalMedicine 25, doi:10.1016/j.eclinm.2020.100446 (2020).
10 Ellington S, S. P., Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–June 7, 2020. . MMWR Morb Mortal Wkly Rep doi:http://dx.doi.org/10.15585/mmwr.mm6925a1 (2020).
11 Sutton, D., Fuchs, K., D’Alton, M. & Goffman, D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. New England Journal of Medicine 382, 2163-2164, doi:10.1056/NEJMc2009316 (2020).
12 Public Health England. Disparities in the risk and outcomes of covid-19. (2020).
13 Garcia, R., Ali, N., Papadopoulos, C. & Randhawa, G. Specific antenatal interventions for Black, Asian and Minority Ethnic (BAME) pregnant women at high risk of poor birth outcomes in the United Kingdom: a scoping review. BMC Pregnancy and Childbirth 15, 226, doi:10.1186/s12884-015-0657-2 (2015).
14 Knight, M. et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ 369, m2107, doi:10.1136/bmj.m2107 (2020).
15 Pareek, M. et al. Ethnicity and COVID-19: an urgent public health research priority. Lancet 395, 1421-1422, doi:10.1016/S0140-6736(20)30922-3 (2020).
16 Zhao, Y. et al. Single-cell RNA expression profiling of ACE2, the receptor of SARS-CoV-2. bioRxiv, 2020.2001.2026.919985, doi:10.1101/2020.01.26.919985 (2020).
17 Valdes, G. et al. Distribution of angiotensin-(1-7) and ACE2 in human placentas of normal and pathological pregnancies. Placenta 27, 200-207, doi:10.1016/j.placenta.2005.02.015 (2006).
18 Levy, A. et al. ACE2 expression and activity are enhanced during pregnancy. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 295, R1953-R1961, doi:10.1152/ajpregu.90592.2008 (2008).
19 Wang, C., Zhou, Y.-H., Yang, H.-X. & Poon, L. C. Intrauterine vertical transmission of SARS-CoV-2: what we know so far. Ultrasound in Obstetrics & Gynecology 55, 724-725, doi:10.1002/uog.22045 (2020).
20 Chen, H. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet 395, 809-815, doi:10.1016/S0140-6736(20)30360-3 (2020).
21 Zeng, L. et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatrics, doi:10.1001/jamapediatrics.2020.0878 (2020).
22 Dong, L. et al. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA, doi:10.1001/jama.2020.4621 (2020).
23 Zeng, H. et al. Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. JAMA 323, 1848-1849, doi:10.1001/jama.2020.4861 (2020).
24 Palmeira, P., Quinello, C., Silveira-Lessa, A. L., Zago, C. A. & Carneiro-Sampaio, M. IgG placental transfer in healthy and pathological pregnancies. Clin Dev Immunol 2012, 985646, doi:10.1155/2012/985646 (2012).
25 Institute for Infection and Immunity. periCOVID - Understanding COVID-19 Infection in Women and Their Babies, (2020).