Findings of a recently published systematic review of 77 studies concluded pregnant women who had been diagnosed with COVID-19 were more likely to have fewer symptoms than their nonpregnant peers, but more likely to be admitted to critical care units and require invasive ventilation. Risk factors for complications included older maternal age, higher body mass index, and comorbidities. Infected women were more likely to have preterm births, with newborns at greater risk for neonatal intensive care unit admission (Allotey et al., 2020). It has yet to be determined if preterm births among women with severe COVID-19 represent a significant association, or if these births are associated with preexisting factors (Pirkle, 2020). More clinical trials and systematic reviews are critical to assess evidence on appropriate care of childbearing women with the virus (Pirkle).

Women and babies in areas of the world with limited health care resources are likely to have limited access to care during the pandemic. Global organizations are working together to generate and share suggestions for appropriate clinical care for pregnant and breastfeeding women and babies. The Partnership for Maternal, Newborn, and Child Health (2020), which includes >1,000 organizations across 192 countries has innovative evidence-based toolkits to guide clinical care for women during the childbearing year. They promote rights of pregnant women with COVID-19 to have access to respectful, woman-centered maternity care by skilled attendants. The Pan American Health Organization (2020) provides tools focusing on maternal and perinatal care during COVID-19. The United Nations Children's Fund (2020) offers extensive information about pregnant mothers and babies born during the COVID-19 pandemic and how they are threatened by strained health systems and disruptions in services. Jhpiego (2020), an international nonprofit health organization sponsored by Johns Hopkins, has developed a training program for COVID-19 case investigators and contract tracers. Advice on COVID-19 and maternal and reproductive health in humanitarian settings is offered by READY: Global Readiness for Major Disease Outbreak Response (2020), led by the United States Agency for International Development and Save the Children. Guidance in humanitarian and fragile settings is critical to the health and wellbeing of women and children globally in the pandemic.

According to the Centers for Disease Control and Prevention COVID-19 Data Tracker, between January 21 and March 31, 2021, there were ~30 million cases of COVID-19 in the United States and ~550,000 deaths. There is a call for inclusion of pregnant women in clinical trials testing interventions although they are considered a clinically vulnerable group. Safety and efficacy in this population must be assessed (Taylor et al., 2020). Provision of evidence-based care for childbearing women is still a work in progress that is rapidly developing (Pirkle et al., 2020). More data are needed for evidence-based clinical care for COVID-19 positive childbearing women. Nurse researchers and clinicians have the opportunity to make critical contributions to these evolving data.

References