• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.4
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• pp.91-104
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• 2022

Objectives: This study was performed to review the impact of Coronavirus disease 2019 (COVID-19) infection during pregnancy and the applicability of traditional Chinese medicine (TCM) on COVID-19 infection during pregnancy. Methods: We searched 6 data bases on August, 2022 and articles about the impact of COVID-19 infection during pregnancy, TCM treatment of COVID-19 infection, TCM treatment of pregnancy common cold (姙娠 感冒) or cough (姙娠 咳嗽) were reviewed. Results: COVID-19 infection can bring out negative effects both on pregnant women and fetus. In the case of COVID-19 infection during pregnancy, the symptoms and treatment are similar to those of general COVID-19 infection, but the safety of drug intervention has not been completely verified. Herbal medicine treatment can be applied according to the severity, stage and TCM syndrome types of COVID-19 infection, but the prohibited herbs list during pregnancy and its dosage should be checked carefully. Also, when it comes to pregnancy disease, the effect of "Stabilizing Fetus" should be considered in the perspective of TCM treatment strategy. Glycyrrhizae Radix et Rhizoma, Rhizoma Atractylodis Macrocephalae, Scutellariae Radix have been widely used on COVID-19 infection and the safety of them during pregnancy have been verified. In the case of acupuncture treatment, acupoints also can be selected according to the severity, symptoms, and TCM syndrome types of COVID-19, but acupoints with strong Qi sensitivity or acupoints located in lower abdomen should be avoided during pregnancy. Conclusions: TCM treatment can be applied to COVID-19 infection during pregnancy. Clinical studies and systematic reviews of the efficacy and safety of TCM treatment on COVID-19 infection during pregnancy are required.

• Women's Health Nursing
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• v.29 no.1
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• pp.44-54
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• 2023

Purpose: Uncertainty and restrictions on daily life have increased fear, stress, and depression during the coronavirus disease 2019 (COVID-19) pandemic. Depression is the most common mental health problem in pregnant women. The purpose of this study was to evaluate the levels of fear and stress related to COVID-19 experienced by pregnant women, as well as their levels of depression, and to examine the factors associated with depression during pregnancy. Methods: This was a cross-sectional, correlational study conducted among 153 pregnant women who visited a maternity hospital in Busan, South Korea. A self-reported questionnaire was used for data collection from December 18, 2021 to March 8, 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression. Results: Pregnant women experienced a moderate level of fear related to COVID-19, with an average score of 21.55±4.90. The average score for depression during pregnancy was 14.86±11.10, with 50.3% of the participants experiencing depression (≥13). The factors associated with depression during pregnancy were fear of COVID-19, contact with a confirmed case of COVID-19, being in the third trimester of pregnancy, high stress levels due to difficulties experienced from social distancing measures, and unintended pregnancy. These five statistically significant factors explained 35.0% of variance in depression during pregnancy. Conclusion: Considering the prevalence of depression in pregnant women during the COVID-19 pandemic, it is necessary to develop interventions to reduce anxiety by providing correct information and alleviating the stress of social distancing.

• CELLMED
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• v.11 no.4
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• pp.20.1-20.23
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• 2021

Background: The pandemic COVID-19 caused by a novel coronavirus SARS-COV-2 has spread like a forest fire. This disease may have serious consequences for pregnant women. Presently, no specific drugs or vaccines exist to battle this disease and researches are underway. Unani medicine has a unique role in prevention and management during epidemics. Here, we reviewed the overview of COVID-19 infection and pregnancy, concept and practices in Unani medicine for flu-like epidemics in general and pregnancy, and safety of Unani drugs for the prevention and treatment of mild symptomatic cases of COVID-19 during pregnancy. Methodology: Unani classical texts and pharmacopoeia were meticulously explored for concepts and practices for flu-like epidemic diseases. Further, we browsed scientific databases such as PubMed, Scopus and others for an overview, epidemics and Unani medicine, effectiveness and safety of Unani drugs in COVID-19 and pregnancy. Results: Unani medicine includes prevention and management of flu-like epidemic include quarantine and isolation, aromatic herbal drugs fumigation and spraying for environmental disinfection, ilaj bid tadbir for health promotion and use of health-protecting drugs and symptom-specific drugs in general and related to pregnancy. Lahsun, asalussus, behidana, banafsha, zanjabeel, unnab, etc are in use since antiquity for the prevention and treatment of asymptomatic and mildly symptomatic pregnant women during infectious and epidemic diseases. Conclusion: Currently, the aforementioned plants are proven for antiviral, antioxidant, immunomodulatory and anti-inflammatory activities, probably useful in the COVID-19 pandemic. Additionally, scientific studies have provided new insight into the mechanism underlying the therapeutic effect of Unani medicines that are safe in pregnancy.

• Women's Health Nursing
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• v.29 no.4
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• pp.274-290
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• 2023

Purpose: This study investigated the effects of prenatal education characteristics, pandemic-related pregnancy stress, and health behaviors during pregnancy on prenatal depression in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The participants were 180 pregnant Korean women, recruited from internet communities for pregnancy preparation, childbirth, and childcare, from July 5 to 15, 2022. The collected data were analyzed using the t-test, analysis of variance, the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple regression analysis. Results: The scores for pandemic-related pregnancy stress (24.50±6.37) and health behaviors during pregnancy (67.07±9.20) were high. Nearly half of the participants (n=89, 49.4%) presented with prenatal depression, with scores of 10 or greater. Prenatal depression had a positive correlation with gestational age (r=.18, p=.019) and pandemic-related pregnancy stress (r=.27, p<.001), and a negative correlation with health behaviors during pregnancy (r=-.42, p<.001). The factors associated with prenatal depression were pandemic-related pregnancy stress (t=4.70, p<.001), marital satisfaction (dissatisfied) (t=3.66, p<.001), pregnancy healthcare practice behaviors (t=-3.31, p=.001), family type (weekend couple) (t=2.84, p=.005), and gestational age (t=2.32, p=.022). The explanatory power of these variables was 38.2%. Conclusion: Since participants had a high level of prenatal depression during the pandemic, and infectious diseases such as COVID-19 may recur, strategies should be developed to improve pregnant women's mental health with consideration of the unique variables that are relevant in a pandemic. It is also necessary to develop efficient online prenatal education programs that can be implemented even in special circumstances such as social distancing, and to evaluate their effectiveness.

• Journal of Microbiology and Biotechnology
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• v.32 no.9
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• pp.1098-1102
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• 2022

The placenta is a captivating multifunctional organ of fetal origin and plays an essential role during pregnancy by intimately connecting mother and baby. This study explicates placental pathology and information about 25 placentas collected from the mothers infected with novel coronavirus (SARS-COV-2). So far, congenital transmission of SARS-CoV-2 seems to be remarkably uncommon in spite of many cases of COVID-19 during pregnancy. Out of the 25 placental tissue samples collected, none has shown gene expression of SARS-CoV-2 when confirmed by RT-PCR. At the same time, nasal and throat swab samples collected from newborns of SARS-CoV-2-positive mothers correspondingly tested negative by RT-PCR. The shielding properties of placental barriers against viral infections from mothers to newborns remains a mystery. Major histopathological findings have been recorded as choriodecidual tissue with necrosis, intramural fibrin deposition, chorionic villi with fibrosis, and calcification. Moreover, although recent findings are insufficient to prove direct placental transmission of COVID-19, the abundance of angiotensin-converting enzymes-2 (ACE-2) on the placental surface could potentially contribute to unpleasant outcomes during pregnancy as SARS-CoV-2 gains access to human cells via ACE-2. Finally, the significance of these findings is vague and needs further study.

• Journal of Preventive Medicine and Public Health
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• v.54 no.6
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• pp.422-430
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• 2021

Objectives: Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19. Methods: The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression. Results: Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative. Conclusions: Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.1
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• pp.2-8
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• 2022

Humanity is in the midst of the coronavirus disease 2019 (COVID-19) pandemic, and vaccines-including mRNA vaccines-have been developed at an unprecedented speed. It is necessary to develop guidelines for vaccination for people undergoing treatment with assisted reproductive technology (ART) and for pregnancy-related situations based on the extant laboratory and clinical data. COVID-19 vaccines do not appear to adversely affect gametes, embryos, or implantation; therefore, active vaccination is recommended for women or men who are preparing for ART. The use of intravenous immunoglobulin G (IVIG) for the treatment of immune-related infertility is unlikely to impact the effectiveness of the vaccines, so COVID-19 vaccines can be administered around ART cycles in which IVIG is scheduled. Pregnant women have been proven to be at risk of severe maternal and neonatal complications from COVID-19. It does not appear that COVID-19 vaccines harm pregnant women or fetuses; instead, they have been observed to deliver antibodies against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) to the fetus. Accordingly, it is recommended that pregnant women receive COVID-19 vaccination. There is no rationale for adverse effects, or clinical cases of adverse reactions, in mothers or neonates after COVID-19 vaccination in lactating women. Instead, antibodies to SARS-CoV-2 can be delivered through breast milk. Therefore, breastfeeding mothers should consider vaccination. In summary, active administration of COVID-19 vaccines will help ensure the safe implementation of ART, pregnancy, and breastfeeding.

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.157-164
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• 2021

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, a small number of coronavirus disease 2019 (COVID-19) cases in neonates have been reported worldwide. Neonates currently account for only a minor proportion of the pediatric population affected by COVID-19. Thus, data on the epidemiological and clinical features of COVID-19 in neonates are limited. Approximately 3% of neonates born to mothers with COVID-19 reportedly tested positive for SARS-CoV-2. Current limited data on neonates with COVID-19 suggest that neonatal COVID-19 shows a relatively benign course despite a high requirement for mechanical ventilation. However, neonates with pre-existing medical conditions and preterm infants appear to be at a higher risk of developing severe COVID-19. The greatest perinatal concern of the COVID-19 pandemic is the possibility of vertical transmission, especially transplacental transmission of SARS-CoV-2. Although direct evidence of the vertical transmission of SARS-CoV-2 is lacking, its possibility during late pregnancy cannot be ruled out. This review summarizes available case studies on COVID-19 in neonates and introduces what is currently known about neonatal COVID-19 with focus on its vertical transmission.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.273-282
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• 2021

Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, resulting in a pandemic. The virus enters host cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2). These enzymes are widely expressed in reproductive organs; hence, coronavirus disease 2019 (COVID-19) could also impact human reproduction. Current evidence suggests that sperm cells may provide an inadequate environment for the virus to penetrate and spread. Oocytes within antral follicles are surrounded by cumulus cells, which rarely express ACE2 and TMPRSS2. Thus, the possibility of transmission of the virus through sexual intercourse and assisted reproductive techniques seems unlikely. Early human embryos express coronavirus entry receptors and proteases, implying that human embryos are potentially vulnerable to SARS-CoV-2 in the early stages of development. Data on the expression of ACE2 and TMPRSS2 in the human endometrium are sparse. Moreover, it remains unclear whether SARS-CoV-2 directly affects the embryo and its implantation. A study of the effect of SARS-CoV-2 on pregnancy showed an increase in preterm delivery. Thus, vertical transmission of the virus from mother to fetus in the third trimester is possible, and further data on human reproduction are required to establish this possibility. Based on analyses of existing data, major organizations in this field have published guidelines on the treatment of infertility. Regarding these guidelines, despite the COVID-19 pandemic, reproductive treatment is crucial for the well-being of society and must be continued under suitable regulations and good standard laboratory practice protocols.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.11-23
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• 2020

Coronavirus disease 2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates can suffer from COVID-19, and children may spread the disease in the community. This review summarizes what is currently known about COVID-19 in children and adolescents.