Is COVID-19 disease more severe in pregnant women?

Is COVID-19 disease more severe in pregnant women?

Last Reviewed : 12/16/2020
Is COVID-19 disease more severe in pregnant women?

Pregnancy is considered as an immunocompromised state. Any infection in immunocompromised individuals can be more fatal when compared to other healthy individuals. In pregnancy, heart and lung systems are already in a compromised state. Pregnant women are prone to develop severe infection due to any viral illness. In 2009, pregnant women accounted for less than 1% of patients infected with Swine Flu, but they accounted for 5% of all Swine Flu-related deaths. The case fatality rate of SARS-CoV infection among pregnant women is up to 25%. The same concern has been smoldering since the Novel Coronavirus pandemic started in December 2019. There has not been extensive research on Novel Coronavirus effects on pregnancy, however, available research studies did not show a difference in the severity of COVID-19 illness in pregnant women.

The largest study so far included 38 pregnant women. Few of the pregnant women had pneumonia and also required ICU level of care. No significant difference was identified in pregnant women when compared to other affected individuals. Another study included 15 pregnant women with COVID-19 pneumonia. Eleven patients had successful delivery (ten cesarean deliveries and one normal vaginal delivery) during the study period and four patients were still pregnant at the end of the study period. No cases of neonatal death, stillbirth or abortion were reported. There appears to be some risk of premature rupture of membranes, preterm delivery, fetal tachycardia and fetal distress when the infection occurs in the third trimester of pregnancy.

Fever and cough were the most common symptoms of COVID-19 pneumonia in pregnant women. CT scan images obtained before and after delivery showed no signs of pneumonia aggravation after delivery. Progression and recovery of COVID-19 illness were similar to other healthy individuals.

The research studies available are limited and smaller in scale. However, based on multiple studies so far, pregnant women seem to be at similar risk as any other individual. Even though these data are promising, pregnant women will require special attention in relation to prevention, diagnosis and management. Pregnant women with COVID-19 illness may need more frequent doctor visits than normal and a higher level of care than other pregnant women.



  1. Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection. Chen D et al. Int J Gynaecol Obstet. 2020 Mar 20. doi: 10.1002/ijgo.13146
  2. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Poon LC et al. Ultrasound Obstet Gynecol. 2020 Mar 11. doi: 10.1002/uog.22013
  3. What are the risks of COVID-19 infection in pregnant women? Qiao J. Lancet. 2020 Mar 7;395(10226):760-762. doi: 10.1016/S0140-6736(20)30365-2
  4. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. Yangli Liu et al. J Infect. 2020 Mar 4. pii: S0163-4453(20)30109-2. doi: 10.1016/j.jinf.2020.02.028
  5. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Liang H et al. Acta Obstet Gynecol Scand. 2020 Apr;99(4):439-442. doi: 10.1111/aogs.13836

Please leave your comments:

Related Articles