Maternal Health Impacts of COVID-19

The emergence of COVID-19 has posed multifaceted challenges for maternal health, spanning direct viral effects on pregnant women to indirect consequences of disrupted health services. Pregnant individuals face increased risk of severe illness, intensive care admission and obstetric complications, particularly in the presence of comorbidities or limited vaccine coverage. Vertical transmission remains uncommon but is now documented, underscoring the need to understand placental pathology. Pandemic‐related restrictions and resource reallocation have also led to rises in stillbirth and maternal mortality in some regions, alongside declines in antenatal visits and mental‐health deterioration. Conversely, widespread vaccination campaigns have demonstrated robust protective benefits for both mothers and infants, reducing severe disease, adverse birth outcomes and neonatal hospitalisation. This evolving evidence base highlights the importance of equitable access to vaccines, maintenance of high-quality intrapartum care and ongoing surveillance to safeguard maternal and perinatal well-being worldwide.

Research from Nature Portfolio

Recent studies have quantified the protective impact of antenatal vaccination on neonates. One large cohort analysis revealed that two or more mRNA vaccine doses during pregnancy conferred high effectiveness against infant SARS-CoV-2 infection in the first months of life, with protection waning more rapidly against the Omicron variant than against Delta. Hospitalisation rates were substantially lower among infants born to vaccinated mothers. In mechanistic work on rare cases of mother-to-fetus transmission, researchers confirmed transplacental passage of SARS-CoV-2 by demonstrating maternal viremia, placental infection with associated inflammation and subsequent neonatal viremia accompanied by neurological signs. These findings clarify both the benefits of maternal immunisation and the pathological pathways underpinning vertical transmission.

Maternal Health Impacts of COVID-19 publication trend

The graph below shows the total number of articles in maternal health impacts of covid-19 across all publications each year (not limited to Nature Index journals).

Technical terms

Transplacental transmission: Passage of a pathogen from mother to fetus across the placental barrier.

Vaccine effectiveness: Proportionate reduction in disease occurrence among vaccinated individuals under real-world conditions.

Maternal morbidity: Any health condition attributed to pregnancy or childbirth that negatively impacts the mother’s well-being.

Perinatal outcomes: Health events affecting the fetus or neonate from the onset of labour through the first week of life.

Viremia: The presence of virus particles in the bloodstream, indicating systemic infection.

Immunoglobulin G (IgG): The main class of antibody that crosses the placenta to provide passive immunity to the fetus.

References

1. Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study. The Lancet (2023).
2. Effect of COVID-19 vaccination and booster on maternal–fetal outcomes: a retrospective cohort study. The Lancet Digital Health (2023).
3. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. Nature Communications (2023).
4. Transplacental transmission of SARS-CoV-2 infection. Nature Communications (2020).
5. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. The Lancet Global Health (2021).