Pregnancy and COVID-19
Preeclampsia is a pregnancy complication characterized as hypertension,
proteinuria and usually begins after 20 weeks gestation period which is
a major cause of maternal deaths and fetal morbidity and mortality and
Lumbers et al. reported that the RAAS system undergoes major changes
during preeclampsia (Lumbers & Pringle,
2014). Levels of Ang II and aldosterone increase after 20 weeks of
gestation in women that causes preeclampsia. To counteract this, there
is compensatory up-regulation of 2 to produce Ang (1-7), a vasodilator
and reduces the aldosterone production
(Bharadwaj et al., 2011;
Levy, Yagil, Bursztyn, Barkalifa, Scharf
& Yagil, 2008). The reports on Zika, H1N1 and SARS-CoV infection
during pregnancy linked these infections with preterm birth, maternal
death and abortions (Ksiezakowska,
Laszczyk, WilczyĆski & Nowakowska, 2008;
Rasmussen, Smulian, Lednicky, Wen &
Jamieson, 2020). Till now, the implications of maternal SARS-CoV-2
infection on the fetal health are unknown, however. reports shows that
during pregnancy and preeclampsia 2 is highly expressed in the placenta,
maternal-fetal interface, fetal tissues such as liver, heart, and lung
which may facilitate the SARS-CoV-2 transmission from infected mother to
fetus which may increase the risk to neonates
(Levy, Yagil, Bursztyn, Barkalifa, Scharf
& Yagil, 2008; Li, Chen, Zhang, Xiong &
Li, 2020; Yang, Shang, Zhang, Li & Liu,
2013). Reports also showed that pregnant females infected with virus
experienced decreased fetal movement, anemia, dyspnea, intrauterine
growth restriction and newborn is infected with SARS-CoV-2
(Chen et al., 2020a;
Dashraath et al., 2020;
Di Mascio et al., 2020). Hence, there is
a reason for the worry as SARS-CoV-2 might interact with highly
expressed ACE 2 in pregnancy and may be responsible for fetal morbidity
and mortality.