COVID-19 in pregnancy in South Africa : tracking the epidemic and defining the natural history

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Authors

Fairlie, Lee
Sawry, Shobna
Patel, Faeezah
Balkus, Jennifer E.
Kalk, Emma
Mutevedzi, Portia
Technau, Karl-Gunter
Yates, Laura M.
Slogrove, Amy
Ballot, Daynia

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Volume Title

Publisher

Health and Medical Publishing Group

Abstract

South Africa (SA) has seen a rapid increase in COVID-19 infections in recent weeks, with cases exceeding 40 000 in early June and anticipated to escalate rapidly as lockdown is eased. The country also has the largest HIV burden globally, and poor maternal and child health indices in many parts. Although early indications were that COVID-19 infection does not worsen pregnancy and birth outcomes, recent reports have raised fresh concerns. Preterm birth, neonatal pneumonia[9-11] and cases of vertical transmission and postpartum infections have been reported, including in SA. Some maternal deaths related to COVID-19 have occurred, possibly linked to haemodynamic changes immediately postpartum and/or to the thrombogenic nature of both pregnancy and COVID- 19. Maternal wellbeing in pregnant women with COVID-19 infection is a major concern, as these women often have high anxiety about infecting their newborn child, and may experience challenging interactions with healthcare providers and community stigma. Most evidence on COVID-19 and pregnancy to date is limited to case series, involves only symptomatic women without HIV, and is almost exclusively from high-income countries. Cohort data across a range of settings and population groups are the only means of fully understanding the natural history, clinical disease spectrum and risks of COVID-19 in pregnant women, fetuses and infants.

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Keywords

South Africa (SA), Coronavirus disease 2019 (COVID-19), COVID-19 pandemic, Birth outcomes, Pregnancy

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Citation

Fairlie, L., Sawry, S., Patel, F. et al. 2020, 'COVID-19 in pregnancy in South Africa : tracking the epidemic and defining the natural history', South African Medical Journal, vol. 110, no. 8, pp. 728-731.