Pregnancy and COVID-19, a brief review

  • Olga Vasylyeva Rochester General Hospital; 1425 Portland Ave, Rochester, NY 14621
Keywords: COVID-19, Pregnancy, Women


COVID-19 is a novel coronavirus capable of causing a severe acute respiratory syndrome. First identified in December 2019 in Wuhan, China, the virus spread around the world and is characterized as a pandemic by the World Health Organization. According to Johns Hopkins Coronavirus Resource Center, presently total confirmed cases mounted 156,400 with total death of 5,833 around the world, among them 2,952 cases in the US and 57 deaths.  This article summarizes what is presently known about COVID-19 infection in pregnant women, and review unique risk factors for severity of viral illnesses among pregnant women.

Author Biography

Olga Vasylyeva, Rochester General Hospital; 1425 Portland Ave, Rochester, NY 14621
Infection Disease Department


1. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Available on-line:

2. World Health Organization. Coronavirus updates, press release. WHO characterizes COVID-19 as a pandemic. 11 March 2020. Available online:

3. Johns Hopkins University of Medicine Coronavirus Resource Center. COVID-19 Map: (Last reviewed 3/15/2020)

4. Kourtis AP, Read JS, Jamieson D. Pregnancy and infection. N Engl J Med. 2014 Jun 5: 370(23): 2211-2218. Available online:

5. Racicot K, Kwon J-Y, Also P, Silasi M, Mor G. Understanding the complexity of the immune system during pregnancy. Am J Reprod Immunol. 2014 Aug; 72(2): 107-116. Available online:

6. Robinson DP, Klein SL. Pregnancy and pregnancy-associated hormones alter immune response and disease pathogenesis. Horm Behav. 2012 Aug; 62(3) 263-271. Available online:

7. Jones LA, Kreem S, Shweash M, Paul A, et al. Differential Modulation of TLR3- and TLR4-Mediated Dendritic Cell Maturation and Function by Progesterone. J Immunol October 15, 2010, 185 (8) 4525-4534. Available online:

8. Mjösberg J, Svensson J, Johansson E, et al. Systemic reduction of functionally suppressive CD4dimCD25highFoxp3+ Tregs in Human Second Trimester Pregnancy Is Induced by Progesterone and 17β-Estradiol. Available online:

9. Cherpes TL, Busch JL, Sheridan BS, et al. Medroxyprogesterone Acetate Inhibits CD8+ T Cell Viral-Specific Effector Function and Induces Herpes Simplex Virus Type 1 Reactivation. J Immunol July 15, 2008, 181 (2) 969-975. Available online:

10. Piccinni MP, Giudizi MG, Biagiotti R, et al. Progesterone favors the development of human T helper cells producing Th2-type cytokines and promotes both IL-4 production and membrane CD30 expression in established Th1 cell clones. J Immunol July 1, 1995, 155 (1) 128-133

11. Berger A. Th1 and Th2 responses: what are they? BMJ. 2000 Aug 12; 321(7258): 424. Available online: 10.1136/bmj.321.7258.424

12. Savita, Rai U. Sex steroid hormones modulate the activation of murine peritoneal macrophages: receptor mediated modulation. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol.1998 Feb;119(2):199-204

13. Straub RH. The complex role of estrogens in inflammation. Endocrine Reviews, Volume 28, Issue 5, 1 August 2007, Pages 521–574. Available online:

14. Rettew JA, Huet YM, Marriott I. Estrogens augment cell surface TLR4 expression on murine macrophages and regulate sepsis susceptibility in vivo. Endocrinology, 2009 Aug;150(8):3877-84. Available online:

15. Nakaya M, Tachibana H, Yamada K. Effect of Estrogens on the Interferon-γ Producing Cell Population of Mouse Splenocytes. 2006 Volume 70 Issue 1 Pages 47-53

16. Ding J, Zhu BT. Unique effect of the pregnancy hormone estriol on antigen-induced production of specific antibodies in female BALB/c mice. Steroids. 2008 Mar;73(3):289-98. Epub 2007 Nov 9

17. Groer ME, Jevitt C, Ji M. Immune changes and dysphoric moods across the postpartum. Am J Reprod Immunol. Available online: 10.1111/aji.12322

18. Singh N, Perfect JR. Immune reconstitution syndrome and exacerbation of infections after pregnancy. Clinical Infectious Diseases, Volume 45, Issue 9, 1 November 2007, Pages 1192–1199. Available online

19. Halperin SA, Langley JM, Ye L, et al. A Randomized Controlled Trial of the Safety and Immunogenicity of Tetanus, Diphtheria, and Acellular Pertussis Vaccine Immunization During Pregnancy and Subsequent Infant Immune Response. Clinical Infectious Diseases, Volume 67, Issue 7, 1 October 2018, Pages 1063–1071. Available online:

20. Kay AW, Blish CA. Immunogenicity and clinical efficacy of influenza vaccination in pregnancy. Front Immunol. 2015; 6: 289. Available online: 10.3389/fimmu.2015.00289

21. Munoz FM, Jackson LA, Swamy GK, et al. Safety and immunogenicity of seasonal trivalent inactivated influenza vaccines in pregnant women. Vaccine. 2018 Dec 18;36(52): 8054-8061

22. Sur DK, Wallis DH, O`Connell TX. Vaccination in pregnancy. Am Fam Physician. 2003 Jul 15;68(2):299-309. Available online:

23. World Health Organization. Global Advisory Committee on Vaccine Safety. Safety of immunization during pregnancy. Review of the evidence. 2014. Assessed online at

24. Soma-Pillay P, Nelson-Piercy C, Heli T, et al. Physiological changes in pregnancy. Cardiovascular J Afr. 2016 Mar-Apr; 27(2): 89-94. Available online:

25. Siston AM, Rasmussen SA, Honein MA, et al. Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States. JAMA. 2010;303(15):1517-1525. Available online: doi: 10.1001/jama.2010.479

26. Jamieson DJ, Theiler RN, Rasmussen SA. Emerging infections and pregnancy. Emerg Infect Dis. 2006 Nov; 12(11): 1638-1643

27. Wong SF, Chow KM, Leung TN. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004 Jul; 191(1): 292-7

28. Stockman LJ, Lowther SA, Coy K, et al. SARS during pregnancy, United States. Emerg Infect Dis. 2004 Sep; 10(9): 1689-1690. Available online:

29. Zhang JP, Wang YH, Chen LN, et al. Clinical analysis of pregnancy in second and third trimesters complicated severe acute respiratory syndrome. Zhonghua Fu Chan Ke Za Zhi. 2003 Aug; 38(8):516-20

30. Jeong SY, Sung SI, Sung JH, et al. MERS-CoV Infection in a pregnant woman in Korea. J Korean Med Sci. 2017 Oct; 32(10): 1717-1720. Available online:

31. Alserehi H, Wali G, Alshukairi A, Alraddadi B. Impact of Middle East Respiratory Syndrome coronavirus (MERS-CoV) on pregnancy and perinatal outcome. BMC Infect Dis. 2016 Mar 2;16:105. Available online doi: 10.1186/s12879-016-1437-y

32. Assiri A, Abedi GR, Masri MA, et al. Middle East Respiratory syndrome coronavirus infection during pregnancy: a report of 5 cases from Saudi Arabia. Clin Infect Dis. 2016 Oct 1;63(7):951-3. Available online doi: 10.1093/cid/ciw412

33. Racicot K, Mor G. Risks associated with viral infections during pregnancy. J Clin Invest. 2017 May 1; 127(5): 1591-1599. Available online:

34. Chen H, Guo J, Wang C, Luo F et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809. Available online:

35. Zhu H, Wang L, Fang C, Peng S et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51. Available online:

36. China CCDC. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. Vital surveillance: The epidemiological characteristics of an outbreak of 2019 novel coronavirus disease (COVID-19) – China, 2020. February 17, 2020. Available online:

37. The American College of Obstetricians and Gynecologists. Practice Advisory: Novel Coronavirus 2019 (COVID019), Published online on March 13, 2020. Available online at
How to Cite
Vasylyeva, O. (2020). Pregnancy and COVID-19, a brief review . International Journal of Integrative Pediatrics and Environmental Medicine, 5(1).