From the Guidelines
Long COVID can potentially have severe impacts on pregnancy, particularly in women over 35 years of age with comorbidities, and thus, close monitoring and management are crucial to prevent adverse outcomes. The effects of Long COVID on pregnancy are a significant concern, as it may lead to persistent symptoms that affect maternal health and pregnancy outcomes 1. Women with Long COVID may experience fatigue, shortness of breath, brain fog, and other symptoms that can complicate pregnancy, exacerbating normal pregnancy discomforts and making it more challenging to manage daily activities.
Some evidence suggests that Long COVID might increase the risks of complications like preeclampsia, gestational diabetes, or preterm birth, though research is still emerging 1. The underlying mechanism appears related to the inflammatory and immune responses triggered by COVID-19 infection that persist and potentially affect placental function and maternal health systems. Management focuses on symptom relief and close monitoring, with women advised to maintain regular prenatal appointments, discuss all symptoms with healthcare providers, rest adequately, stay hydrated, and follow a nutritious diet.
Breathing exercises may help with respiratory symptoms, while pacing activities can manage fatigue 1. Mental health support is crucial as Long COVID can increase anxiety and depression. Medications for symptom management should only be used under medical supervision, as pregnancy safety profiles must be considered. Women with Long COVID planning pregnancy should ideally optimize their health beforehand and work closely with healthcare providers throughout gestation. Key considerations include:
- Close monitoring of maternal and fetal health
- Management of persistent symptoms
- Prevention of complications such as preeclampsia, gestational diabetes, or preterm birth
- Mental health support
- Collaboration with healthcare providers to optimize pregnancy outcomes.
From the Research
Effects of Long COVID on Pregnancy
- The prevalence of Long COVID-19 in pregnant women varies widely, ranging from 9.3-93% 2
- Common symptoms of Long COVID-19 in pregnant women include fatigue, cognitive dysfunction, respiratory symptoms, and psychological disturbances, with fatigue being the most prevalent 2, 3
- Severe acute COVID-19, obesity, pre-existing mental health conditions, and non-vaccination are identified as key risk factors for developing Long COVID-19 in pregnant women 2, 3
- Women with Long COVID-19 are at a higher risk for adverse maternal and neonatal outcomes, such as preterm birth and increased need for neonatal intensive care 2
Risk Factors and Outcomes
- The severity of acute infection and the presence of comorbidities significantly influence the risk and severity of Long COVID-19 in pregnant women 2, 3
- Hospitalization during acute infection, having one or more symptoms, and having symptoms such as cough and myalgia/arthralgia increase the likelihood of Long COVID-19 in pregnant women 3
- Pulmonary rehabilitation programs may be beneficial for managing Long COVID-19 symptoms in pregnant women, although more research is needed to confirm this 4, 5
Management and Treatment
- There is limited evidence on the effectiveness of specific treatments for Long COVID-19 in pregnant women, although pulmonary rehabilitation programs have shown promise in improving symptoms and functional capacity 4, 5
- Living recommendations for the clinical care of pregnant and postpartum women with COVID-19 have been issued by the National COVID-19 Clinical Evidence Taskforce, including guidelines on mode of birth, breastfeeding, and advanced respiratory support interventions 6