Coronavirus disease 2019 and pregnancy

To the Editors:

We appreciate the interest in our work and the opportunity to respond to the issues raised by Volpato et al.¹ Since the online publication of our paper on February 24, 2020,² data from many additional studies have been published, addressing the effects of coronavirus disease 2019 (COVID-19) on the pregnant woman and her fetus. For example, updates on surveillance data from the United States on COVID-19 and pregnancy were recently published: these data show that among over 400,000 women of childbearing age with symptomatic COVID-19, pregnant women were more likely to be admitted to an intensive care unit, to require invasive ventilation, to receive extracorporeal membrane oxygenation, and to die than nonpregnant women.³ Infants born to these women also seem to be at increased risk: among nearly 4000 infants born to women with COVID-19 during pregnancy in 16 jurisdictions in the United States, infants born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–infected women were more likely to be born preterm (12.9% were preterm, compared with a national estimate of 10.2%).⁴ These data are consistent with a large systematic review that suggests that infants born to mothers with COVID-19 are at a 3-fold increased risk of preterm birth and of neonatal intensive care unit admission.⁵ These findings emphasize the importance of implementation of COVID-19 prevention measures in pregnant women and the importance of collecting data on SARS-CoV-2–infected pregnant women and their infants.