Studies in Sport Medicine

Maternal and neonatal consequences associated with COVID-19 and the role of physical activity during this period: A descriptive review

Document Type : Research Paper

Authors

1 Department of Sports Sciences, Faculty of Humanities, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran.

2 Assistant Professor, Department of Sports Sciences, Faculty of Humanities, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran

3 Dept. of Exercise Physiology, Faculty of Physical Education, Shahid Rajaee Teacher Training University, Tehran, Iran.

Abstract
The global outbreak of Coronavirus 2019 has affected the routine life. The aim of study is to review the background of studies on the clinical symptoms and consequences of Covid-19 infection in pregnant women and their offspring, as well as the role of physical activity on the maternal health. In this survey, all articles in the different databases were searched and investigated by using keywords. The most common maternal/ neonatal complications included fetal and respiratory distress, preterm delivery and mild infection in newborns. Guidelines have recommended physical activity to improve physical and mental condition. Studies have shown that regular physical activity with the moderate intensity can lead to strong immune responses in pregnant women. Due to the limited information, it is necessary to monitor pregnant women and their infants for a long time and to examine the role of physical activity to improve the physical and mental condition.

Keywords

Main Subjects

  1. WHO. Coronavirus disease (COVID-19) Pandemic [cited 2020 Mar 27]. World health organization(WHO). 2020. Available from: https://www.who.int/news-room/q-a-detail/be-active-during-covid-19
  2. Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obs Gynecol 2020 Jun;222(6):521-531.  doi: 10.1016/j.ajog.2020.03.021
  3. Chen Y, Peng H, Wang L, Zhao Y, Zeng L, Gao H, et al. Infants Born to Mothers With a New Coronavirus (COVID-19). Front Pediatr. 2020;8:104.  https://doi.org/10.3389/fped.2020.00104.
  4. Wang W, Zhang Q, Qu F. The potential benefits of Chinese integrative medicine for pregnancy women during the COVID-19 pandemic. Integr Med Res. 2020 Sep;9(3):100461. Available from: https://pubmed.ncbi.nlm.nih.gov/32704474
  5. Peng Z, Wang J, Mo Y, Duan W, Xiang G, Yi M, et al. Unlikely SARS-CoV-2 vertical transmission from mother to child: A case report. J Infect Public Health . 2020 May;13(5):818-820. doi: 10.1016/j.jiph.2020.04.004.
  6. American College of Obstetricians and Gynecologists (ACOG). Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients [cited 2020 Dec 22]. 2020. Available from: https://www.acog.org/patient-resources/faqs/pregnancy/coronavirus-pregnancy-and-breastfeeding#What is COVID19
  7. Dotters-Katz SK, Hughes BL. Considerations for Obstetric Care during the COVID-19 Pandemic. Am J Perinatol. 2020 Jun;37(8):773-779.  doi: 10.1055/s-0040-1710051.
  8. Yang Z, Wang M, Zhu Z, Liu Y. Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. J Matern neonatal Med. 2020 Apr 30; 1-4.
  9. doi: 10.1080/14767058.2020.1759541. 
  10. Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020;99(4):439–42.
  11. Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. J Sport Heal Sci. 2020/02/04. 2020 Mar;9(2):103–4. Available from: https://pubmed.ncbi.nlm.nih.gov/32099716
  12. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian SE, et al. Maternal Death Due to COVID-19 Disease. Am J Obstet Gynecol 2020 Jul;223(1):109.e1-109.e16.  doi: 10.1016/j.ajog.2020.04.030. 
  13.  Hayakawa S, Komine-Aizawa S, Mor GG. Covid-19 pandemic and pregnancy. J Obstet Gynaecol Res [cited 2020 Aug 10]. https://doi.org/10.1111/jog.14384
  14. Fan C, Lei D, Fang C, Li C, Wang M, Liu Y, et al. Perinatal Transmission of COVID-19 Associated SARS-CoV-2: Should We Worry? Clin Infect Dis [cited 2020 Mar 17]. doi: 10.1093/cid/ciaa226.
  15. Schwartz DA. An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med [cited 2020 Mar 17].doi: 10.5858/arpa.2020-0901-SA
  16. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during Pregnancy and Possible Vertical Transmission. Am J Perinatol. 2020 Jun;37(8):861-865.  doi: 10.1055/s-0040-1710050.
  17. Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect [cited 2020 Mar 4]. doi: 10.1016/j.jinf.2020.02.028.
  18. Zhang L, Jiang Y, Wei M, Cheng BH, Zhou XC, Li J, et al. [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. Zhonghua Fu Chan Ke Za Zhi. 2020 Mar 25;55(3):166-171.  doi: 10.3760/cma.j.cn112141-20200218-00111.
  19. Zheng T, Guo J, He W, Wang H, Yu H, Ye H. Coronavirus disease 2019 (COVID-19) in pregnancy: 2 case reports on maternal and neonatal outcomes in Yichang city, Hubei Province, China. Medicine (Baltimore). 2020;99(29).
  20. Xiong X, Wei H, Zhang Z, Chang J, Ma X, Gao X, et al. Vaginal delivery report of a healthy neonate born to a convalescent mother with COVID-19. J Med Virol. 2020;92(9):1657–9.
  21. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet (London, England). 2020 Mar;395(10226):809–15.
  22. Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms Are Not OK: COVID-19 and Maternal Mental Health. Front Glob Women’s Heal. 2020;1:1. https://doi.org/10.3389/fgwh.2020.00001
  23. United Nations Children’s Fund (UNICEF). Navigating pregnancy during the coronavirus disease (COVID-19) pandemic [cited 2020 Sept 08]. United Nations Children’s Fund. Available from: ttps://www.unicef.org/coronavirus/navigating-pregnancy-during-coronavirus-disease-covid-19-pandemic
  24. ACOG. Physical Activity and Exercise During Pregnancy and the Postpartum Period [cited 2020 Apr]. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period.
  25. Davenport MH, McCurdy AP, Mottola MF, Skow RJ, Meah VL, Poitras VJ, et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. Br J Sports Med. 2018 Nov 1;52(21):1376 LP – 1385. Available from: http://bjsm.bmj.com/content/52/21/1376.abstract
  26. Mottola MF, Davenport MH, Ruchat S-M, Davies GA, Poitras VJ, Gray CE, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018 Nov;52(21):1339–46.
  27. Toosi M, Akbarzadeh M. The Effect of Aerobic Exercises on Maternal Outcomes: A Randomized Controlled Clinical Trial. Women’s Heal Bull. 2016;3(4).
  28. Shirvani H, Rostamkhani F. Exercise Considerations during Coronavirus Disease 2019 (COVID-19) Outbreak: A Narrative Review TT  - مروری بر ملاحظات انجام فعالیت‎های ورزشی در طی شیوع بیماری کووید-19. militarymedj. 2020 Apr 1;22(2):161–8.
  29. Leandro CG, Ferreira E Silva WT, Lima-Silva AE. Covid-19 and Exercise-Induced Immunomodulation. Neuroimmunomodulation. 2020;27(1):75–8.
  30. Moldoveanu AI, Shephard RJ, Shek PN. The cytokine response to physical activity and training. Sports Med. 2001 Feb;31(2):115–44.
  31. Acosta-Manzano P, Coll-Risco I, Van Poppel MNM, Segura-Jiménez V, Femia P, Romero-Gallardo L, et al. Influence of a Concurrent Exercise Training Intervention during Pregnancy on Maternal and Arterial and Venous Cord Serum Cytokines: The GESTAFIT Project. J Clin Med. 2019 Nov; 8(11): 1862.
  32. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5–13.
  33. Fang H, Xingfei P, Yingwei Q, Dunjin C. Be aware of misdiagnosis---A 21-Year-Old Primipara with Suspected COVID-19. Int J Gynecol Obstet. 24 Apr 2020, 150(1):119-121. DOI: 10.1002/ijgo.13183 .
  34. Zambrano LI, Fuentes-Barahona IC, Bejarano-Torres DA, Bustillo C, Gonzales G, Vallecillo-Chinchilla G, et al. A pregnant woman with COVID-19 in Central America. Travel Med Infect Dis. 2020;36:101639. doi: 10.1016/j.tmaid.2020.101639.
  35. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Mode of Delivery and Clinical Findings in COVID-19 Infected Pregnant Women in Northern Italy. SSRN Electron J. [cited 2020 Jan 1]. https://doi.org/10.1111/1471-0528.16278
  36. Zamaniyan M, Ebadi A, Aghajanpoor Mir S, Rahmani Z, Haghshenas M, Azizi S. Preterm delivery in pregnant woman with critical COVID-19 pneumonia and vertical  transmission. Prenat diagn. 2020; 10:1002.
  37. Zeng N, Ayyub M, Sun H, Wen X, Xiang P, Gao Z. Effects of Physical Activity on Motor Skills and Cognitive Development in Early Childhood : A Systematic Review. Biomed Res Int. 2017;2017:2760716. doi: 10.1155/2017/2760716.
  38. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020 Feb;9(1):51–60.
  39. Khan S, Peng L, Siddique R, Nabi G, Nawsherwan  undefined, Xue M, et al. Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infect Control Hosp Epidemiol. 2020;1–3.
  40. Iqbal SN, Overcash R, Mokhtari N, Saeed H, Gold S, Auguste T, et al. An Uncomplicated Delivery in a Patient with Covid-19 in the United States. N Engl J Med. 2020 Apr 1;382(16):e34.
  41. Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z. Clinical characteristics of 19 neonates born to mothers with COVID-19. Front Med. 2020 Apr;14(2):193–8.
  42. Xu L, Yang Q, Shi H, Lei S, Liu X, Zhu Y, et al. Clinical presentations and outcomes of SARS-CoV-2 infected pneumonia in pregnant women and health status of their neonates. Sci Bull. 2020 Sep 30; 65(18): 1537–1542.
  43. Chen S, Liao E, Cao D, Gao Y, Sun G, Shao Y. Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Virol. 2020 Sep;92(9):1556-1561.doi: 10.1002/jmv.25789.
  44. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. 2020;
  45. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. Am J Roentgenol. 2020 Mar 18;1–6.
  46. Cao D, Yin H, Chen J, Tang F, Peng M, Li R, et al. Clinical analysis of ten pregnant women with COVID-19 in Wuhan, China: A retrospective study. Int J Infect Dis. 2020;95:294–300.
  47. Alonso Díaz C, López Maestro M, Moral Pumarega MT, Flores Antón B, Pallás Alonso C. First case of neonatal infection due to COVID-19 in Spain. An Pediatría (English Ed. 2020;92(4):237–8.
  48. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020 May;20(5):559–64.
  49. Yang P, Wang X, Liu P, Wei C, He B, Zheng J, et al. Clinical characteristics and risk assessment of newborns born to mothers with COVID-19. J Clin Virol. 2020 Apr;127:104356.
  50. Xia H, Zhao S, Wu Z, Luo H, Zhou C, Chen X. Emergency Caesarean delivery in a patient with confirmed COVID-19 under spinal anaesthesia. Br J anaesthesia. 2020 May; 124(5): e216–e218.
  51. Yang H, Sun G, Tang F, Peng M, Gao Y, Peng J, et al. Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019. J Infect. 2020 Jul; 81(1): e40–e44.
  52. Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. Clin Infect Dis. 2020 Nov 19;71(16):2035-2041. doi: 10.1093/cid/ciaa352.
  53. Khan S, Jun L, Nawsherwan, Siddique R, Li Y, Han G, et al. Association of COVID-19 with pregnancy outcomes in health-care workers and general women. Clin Microbiol Infect. 2020 Jun; 26(6): 788–790.
  54. Carosso A, Cosma S, Borella F, Marozio L, Coscia A, Ghisetti V, et al. Pre-labor anorectal swab for SARS-CoV-2 in COVID-19 pregnant patients: is it time to think about it? Eur J Obstet Gynecol Reprod Biol. 2020 Jun; 249: 98–99.
  55. Buonsenso D, Costa S, Sanguinetti M, Cattani P, Posteraro B, Marchetti S, et al. Neonatal Late Onset Infection with Severe Acute Respiratory Syndrome Coronavirus  2. Am J Perinatol. 2020 Jun;37(8):869-872. doi: 10.1055/s-0040-1710541.  
  56. Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates. JAMA Pediatr. 2020;174(7):722-725. doi:10.1001/jamapediatrics.2020.0878 .
  57. Lu D, Sang L, Du S, Li T, Chang Y, Yang X-A. Asymptomatic COVID-19 infection in late pregnancy indicated no vertical transmission. J Med Virol. 2020 Sep;92(9):1660-1664. doi: 10.1002/jmv.25927.
  58. AlZaghal LA, AlZaghal N, Alomari SO, Obeidat N, Obeidat B, Hayajneh WA. Multidisciplinary team management and cesarean delivery for a Jordanian woman infected with SARS-COV-2: A case report. Case Reports Women’s Heal. 2020;e00212.
  59. Nyenhuis SM, Greiwe J, Zeiger JS, Nanda A, Cooke A. Exercise and Fitness in the age of social distancing during the COVID-19 Pandemic. J Allergy Clin Immunol Pract. Jul-Aug 2020;8(7):2152-2155. doi: 10.1016/j.jaip.2020.04.039. Epub 2020 Apr 28.
  60. Li J, Wang Y, Zeng Y, Song T, Pan X, Jia M, et al. Critically ill pregnant patient with COVID-19 and neonatal death within two hours of birth. Int J Gynecol Obstet. 2020 Jul;150(1):126-128. doi: 10.1002/ijgo.
  61. Breslin N, Baptiste C, Miller R, Fuchs K, Goffman D, Gyamfi-Bannerman C, et al. COVID-19 in pregnancy: early lessons. Am J Obstet Gynecol MFM. 2020 May;2(2):100111.doi: 10.1016/j.ajogmf.2020.100111.
  62. Wang X, Zhou Z, Zhang J, Zhu F, Tang Y, Shen X. A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery. Clin Infect Dis. 2020, 71(15):844-846.
  63. Lowe B, Bopp B. COVID-19 vaginal delivery – a case report. Aust New Zeal J Obstet Gynaecol [cited 2020 Apr 15]. Available from: https://doi.org/10.1111/ajo.13173
  64. Díaz C, Maestro M, Pumarega M, Antón B, Alonso C. First case of neonatal infection due to COVID 19 in Spain. An Pediatría. 2020, 92(4): 237-238.
  65. Aubertin-Leheudre M, Rolland Y. THE IMPORTANCE OF PHYSICAL ACTIVITY TO CARE FOR FRAIL OLDER ADULTS DURING THE COVID-19 PANDEMIC. J Am Med Dir Assoc. 2020 Jul; 21(7): 973–976.
  66. World Health Organisation. Be Active During COVID-19 [cited 2020 Mar 27]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/be-active-during-covid-19
  67. Zhang J, Zhang Y, Huo S, Ma Y, Ke Y, Wang P, et al. Emotional Eating in Pregnant Women during the COVID-19 Pandemic and Its Association with Dietary Intake and Gestational Weight Gain. Nutrients. 2020;12(8):2250.
  68. Torlone E, Sculli MA, Bonomo M, Di Benedetto A, Di Cianni G, Festa C, et al. Recommendations and management of hyperglycaemia in pregnancy during COVID-19 pandemic in Italy. Diabetes Res Clin Pract. 2020;166:108345.
  69. Preis H, Mahaffey B, Heiselman C, Lobel M. Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic. Soc Sci Med. 2020;266:113348.
  70. American College of Obstetricians and Gynecologists (ACOG). Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients [cited 2020 Dec 22]. Available from: https://www.acog.org/patient-resources/faqs/pregnancy/coronavirus-pregnancy-and-breastfeeding#What should pregnant women do to avoid the coronavirus.
  71. Shojaeian N, Shojaei M, Ghasemi A. The Effect of Physical Activity during Pregnancy on Development of Social Skills in Infants: A Short Report TT  - تأثیر فعالیت بدنی طی بارداری بر رشد مهارت‌های اجتماعی اطفال: یک گزارش کوتاه. RUMS_JOURNAL. 2017 Jul 1;16(4):381–8.
  72. WHO regional office for Europe. How to stay physically active during COVID-19 self-quarantine [cited 2020 Mar 25]. Available from: https://www.euro.who.int/en/health-topics/disease-prevention/physical-activity/news/news/2020/3/how-to-stay-physically-active-during-covid-19-self-quarantine
  73. Chua M, Lee J, Sulaiman S, Tan HK. From the frontline of COVID-19 - How prepared are we as obstetricians: a commentary. BJOG [cited 2020 Mar 4]. Available from: https://doi.org/10.1111/1471-0528.16192.
  74. Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J, et al. Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol. 2020 Aug;223(2):240.e1-240.e9.
  75. Simpson RJ, Campbell JP, Gleeson M, Krüger K, Nieman DC, Pyne DB, et al. Can exercise affect immune function to increase susceptibility to infection? Exerc Immunol Rev. 2020;26:8–22.
  76. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynecol Obstet. 2020 Jul 1;150(1):47–52.
  77. Savasi VM, Parisi F, Patanè L, Ferrazzi E, Frigerio L, Pellegrino A, et al. Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2020;136(2).Zhao X, Jiang Y, Zhao Y, Xi H, Liu C, Qu F, et al. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis. 2020 Apr 23;1–12
Studies in Sport Medicine
Volume 11, Issue 26
August 2021
Pages 181-214

  • Receive Date 27 June 2020
  • Revise Date 12 October 2020
  • Accept Date 18 October 2020

Home

Publication Ethics

Submit Manuscript

news

Journal Metrics

Contact Us