Long COVID-19 and pregnancy: A systematic review

The impact of post-acute sequelae of SARS-CoV-2 infection, or Long coronavirus disease 2019 (COVID-19), on pregnant women remains a growing concern. The present systematic review synthesizes current evidence on the prevalence, risk factors and clinical outcomes of Long COVID-19 in pregnant women to improve understanding of its burden and implications for maternal health. A systematic search was conducted in PubMed, Scopus and Google Scholar for studies published between January 2020 and October 2024. Eligible studies included pregnant or postpartum women diagnosed with COVID-19 and followed for at least four weeks post-infection. Data extraction and quality assessment were performed using standardized tools, and the findings were narratively synthesized due to heterogeneity in study designs and outcome measures. A total of 13 studies encompassing 13,729 participants were included. The prevalence of Long COVID-19 varied widely, ranging from 9.3-93%. The most reported symptoms included fatigue, cognitive dysfunction, respiratory symptoms and psychological disturbances, with fatigue being the most prevalent. Severe acute COVID-19, obesity, pre-existing mental health conditions, and non-vaccination were identified as key risk factors for developing Long COVID-19. Several studies reported that women with Long COVID-19 were at a higher risk for adverse maternal and neonatal outcomes, such as preterm birth and increased need for neonatal intensive care. The severity of acute infection and the presence of comorbidities significantly influenced the risk and severity of Long COVID-19. Long COVID-19 is a prevalent condition among pregnant women, with significant variability in reported prevalence rates. It is associated with a range of symptoms that can impact maternal health and pregnancy outcomes. The findings highlight the need for targeted follow-up and management strategies in this population. Standardized definitions and longitudinal studies are essential to further elucidate the long-term impact of COVID-19 during pregnancy.