Sentinel surveillance systems include longitudinal studies and seroprevalence surveys to determine the prevalence and severity of SARS-CoV-2 infections. These data collection methods can be used to determine optimal public health interventions and implement these community-wide changes. Existing records of pregnant patients and mother-baby linked longitudinal studies can facilitate data analysis and determine the solutions to imminent public health concerns. For example, population-based studies help to identify the risks of infection and compare susceptibility within different gestational and social parameters. Existing cohort studies used to observe the incidence of Zika virus can be modified to organize global data collection. The administration of new Covid-19 therapeutics and vaccines need to be constantly evaluated to determine its efficacy within this target population. 

Sentinel Surveillance Systems

Tissue and fluid collection throughout prenatal and delivery care provide a convenient route of data collection. Specifically, routine maternal care can offer insights into SARS-CoV-2 infections within asymptomatic populations and will construct population-based approximations of viral seroprevalence. Currently, sentinel prenatal clinics are used to determine population-based estimates of HIV seroprevalence. Despite the disruption to prenatal care and wellcare visits, past infections, indicated by circulating antibodies, allow health professionals to understand the epidemiology of viral infections in pregnant women. Furthermore, fluid collection can occur directly after delivery and existing cohort studies provide easily accessible blood samples. Samples collected before the global pandemic, indicating the control population, would allow scientists to analyze various microbiomes, including viral pathogens, and detect potential background cross-reactivity. 

Data Collected From Prenatal & Delivery Care

Sentinel surveillance, seroprevalence surveys and sociobehavioral research should be utilized to supply public health experts with the appropriate epidemiological data. 

Tulane University

The Covid-19 global pandemic has become an important epidemiological event that has impacted the lives of many throughout the world. In contrast to neglected tropical diseases, SARS-CoV-2 affects a variety of diverse socioeconomic communities. However, based on epidemiological data, there is a higher seroprevalence within populations of color with comorbidities, such as Type II Diabetes and chronic respiratory conditions. Additionally, pregnant women could be at risk for developing severe symptoms of Covid-19, which requires a prompt and comprehensive response from the public health community. 

A Call for Action for Covid-19 Surveillance & Research During Pregnancy

Buekens, P., Alger, J., Bréart, G., Cafferata, M. L., Harville, E., & Tomasso, G. (2020). A call for action for COVID-19 surveillance and research during pregnancy. The Lancet. Global health, 8(7), e877–e878. https://doi.org/10.1016/S2214-109X(20)30206-0

Pregnant women are not considered high-risk populations and do not receive the same attention from the medical community as older individuals and those with underlying medical conditions. Analysis of new data could convey the social and medical vulnerability of pregnant women. Tissue and blood specimens collected during prenatal care and delivery could determine the population-based estimate of asymptomatic SARS-CoV-2 infections in pregnant women. Currently, the limited available data suggests that pregnant women are not susceptible for severe clinical manifestations of Covid-19. However, case reports lack a large sample pool and are at risk for sampling error. Additionally, reports differ as to whether vertical transmission of SARS-CoV-2 is possible. 

The Disparate Treatment of Pregnant Women

Throughout the gestation period, women undergo immunological changes that make them vulnerable to viral diseases which contribute to respiratory infections and pregnancy complications. Physiological changes attributed to SARS and MERS infections have resulted in adverse pregnancy outcomes. Illnesses associated with high fevers may lead to birth defects, such as neural tube defects. Thus, exposure to SARS-CoV-2 during pregnancy may produce unalterable conditions that affect both the child and the mother. 

Immunological Effects of Pregnancy

The comprehensive public health interventions implemented throughout the Covid-19 pandemic, albeit required, have done a disservice to pregnant women. The restriction of maternal and prenatal services contributes to gender-based violence; impedes a woman’s ability to seek preventative health-care; and leads to severe postpartum depression and other significant mental health problems. Preventive healthcare includes prenatal and well-child visits, which are essential to maintaining the well-being of the mother and child. Mandated healthcare changes, such as the reorganization of labor and delivery rooms to practice social distancing and restricted family access, may contribute to severe psychological repercussions. 

How Pregnant Women Are At Risk During the Covid-19 Pandemic

Research institutions throughout the world must have access to the latest developing research on SARS-CoV-2 in order to provide treatment to vulnerable populations, such as pregnant women. Transparent reporting of scientific research greatly increases the accuracy of data and provides a foundation from which stronger public health interventions can be achieved. Information gleaned from surveillance systems and research will educate medical professionals, allowing them to update clinical procedures and protocols. It is essential that more data is collected in order to determine the significance of the SARS-CoV-2 pandemic on pregnant women and infants. 

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