Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration

Am J Trop Med Hyg. 2020 Dec 28;104(2):461-465. doi: 10.4269/ajtmh.20-1553.

Abstract

In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health's COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa.

MeSH terms

  • Africa South of the Sahara / epidemiology
  • COVID-19 / complications*
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • Coinfection / complications
  • Coinfection / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Intersectoral Collaboration
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Complications, Infectious / virology*
  • Pregnant Women
  • Premature Birth
  • Prospective Studies
  • Research*
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / pathogenicity
  • Socioeconomic Factors