SARS-CoV-2 in the context of past coronaviruses epidemics: Consideration for prenatal care

Abstract

Since December 2019, the novel SARS-CoV-2 outbreak has resulted in millions of cases and more than 200 000 deaths worldwide. The clinical course among nonpregnant women has been described, but data about potential risks for women and their fetus remain scarce. The SARS and MERS epidemics were responsible for miscarriages, adverse fetal and neonatal outcomes, and maternal deaths. For COVID-19 infection, only nine cases of maternal death have been reported as of 22 April 2020, and pregnant women seem to develop the same clinical presentation as the general population. However, severe maternal cases, as well as prematurity, fetal distress, and stillbirth among newborns have been reported. The SARS-CoV-2 pandemic greatly impacts prenatal management and surveillance and raise the need for clear unanimous guidelines. In this narrative review, we describe the current knowledge about coronaviruses (SARS, MERS, and SARS-CoV-2) risks and consequences on pregnancies, and we summarize available current candidate therapeutic options for pregnant women. Finally, we compare current guidance proposed by The Royal College of Obstetricians and Gynaecologists, The American College of Obstetricians and Gynecologists, and the World Health Organization to give an overview of prenatal management which should be utilized until future data appear.

FIGURE 1

Timeline of main events, total number of confirmed cases by WHO, and total number confirmed deaths by WHO from December 2019. WHO, World Health Organization [Colour figure can be viewed at wileyonlinelibrary.com]

FIGURE 2

Number of publication for SARS‐CoV‐2 from December 2019, compared with HIV (1983‐1986) and Zika virus (2016) [Colour figure can be viewed at wileyonlinelibrary.com]