Covid-19 and pregnancy

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Hydroxychloroquine early in pregnancy and risk of birth defects

Am J Obstet Gynecol Sep 2020

Much has been written about the unproven efficacy of hydroxychloroquine and covid-19. This article reports a a population-based cohort study that included 2045 hydroxychloroquine-exposed pregnancies ascertained from insurance program data collected from 3 months before LMP to 1 month after delivery. The cohort was limited to women using hydroxychloroquine during the first trimester of pregnancy and women with rheumatic disorders. They found an adjusted relative risk of 1.33 (1.08-1.65) for a daily dose of ≥400 mg and 0.95 (0.60-1.50) for a daily dose of <400 mg for major congenital malformation with no pattern of malformation. While the risk-benefit analysis is positive for most patients with autoimmune rheumatic disorders, the benefits of treatment during pregnancy for coronavirus disease 2019 prophylaxis would need to be balanced against such benefits.

Heartburn Drugs in Pregnancy Tied to Asthma in Babies

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This article reports a recent meta-analysis of largely retrospective cohort studies most of which were deemed to have a strong risk of bias assessment . Despite these caveats it risk of childhood asthma was reported to be  46% increased. The reason for the apparent association is unclear.

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Are Vegan and Vegetarian Diets Safe During Pregnancy?

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Focussing mainly on deficiencies in vitamin B12,  iron, zinc, and the long-chain omega-3 fats. In fact there are no randomised studies of these diets in pregnancies. The little data available suggests that except in cases of extreme deficiency eg.  vegan women with pernicious anaemia, there were no clear associations with bad outcomes. Despite this the author still advised that if a woman’s diet is low in omega-3 fats and has a history, risk, or propensity toward mood disorders, then they should think about supplementation.

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