Consider pregnancy in COVID-19 therapeutic drug and vaccine trials

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131 million women give birth annually. This population is particularly vulnerable to emerging infectious pathogens due to alterations in immune, respiratory, and cardiovascular physiology that occur during pregnancy. Recent outbreaks of severe acute respiratory syndrome, Middle East respiratory syndrome, influenza H1N1, Ebola virus disease, and Zika virus disease exposed high rates of maternal morbidity and mortality, fetal loss, and fetal harm.

Early data regarding pregnancy outcomes in COVID-19 are reassuring: maternal outcomes are similar to non-pregnant adults, and vertical transmission and neonatal infection are rare. However, pregnant women remain at risk of severe disease requiring intensive care, and they deserve equity in access to therapeutic options informed by rigorous scientific data.

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