【《We Chinese in AmericaMedia Editor Tang Zhao, October 17, 2022】Preeclampsia, a little understood complication of pregnancy that each year results in more than 70,000 maternal and 500,000 fetal deaths worldwide. Rates of the illness had been rising steadily in the United States for years, but during the pandemic, the number of cases jumped, according to doctors. No one knows exactly why. (Photo credit: Intercept)

The mystery of preeclampsia cases is part of thegrowing pool of information scientists are sorting through when it comes to the impact of the coronavirus on reproductive health, from a woman’s menstrual cycle and fertility down to possible effects on a baby’s development. Ilhem Messaoudi, a professor of immunology at the University of Kentucky, said she and many of her colleagues have been taken aback by the extent to which pregnancy has been affected by the pandemic. Like many researchers, she had initially thought of covid-19, the disease caused by the SARS-CoV-2 virus, as a respiratory illness and did not expect it to impact reproductive organs. Instead, she and other pregnancy experts have spent the past few years scrambling to understand spikes in maternal complications — first reported anecdotally then verified in several large studies — including an extremely small but nonetheless alarming group of unusual stillbirths. “I was naive,” Messaoudi reflected. “Now I wonder, ‘What else have we been missing?’ 
It will be decades before we know the extent of the coronavirus’s effects on human health. But now, more than 2 years and 9 months since it appeared — a period in which millions of pregnant people have been infected with the virus at least once — researchers have noted some positive signs, some worrisome ones, and many other data points they still aren’t sure how to evaluate, especially since it’s difficult to disentangle the impact of maternal stress during the pandemic from the devastation of the virus itself.
Among the key findings so far about SARS-CoV-2 — by many accounts the most studied virus ever to infect humans — are that fertility appears unaffected by either infections or vaccines. Periods may shift in women after the vaccine but only slightly so and the change appears to be only temporary. But there is more reason for concern with pregnancy itself. While the vast majority of people who are infected do not experience complications, the risk of preeclampsia and other severe issues has been documented to be much higher with infection. 
The biological mechanisms are still unclear, but researchers say they likely start with changes in the blood and immune system of the mothers. Pregnancy can be both magical and brutal as it transforms a person’s body to support another life. Much of the stress is on the heart and circulatory system, with blood volume surging by 30 percent to 50 percent, and the heart growing to pump more blood.
The coronavirus, it turns out, can have a profound impact on that same system. The virus attaches itself to what are known as ACE2 receptors involved in regulating blood pressure and inflammation, and throughout the pandemic, doctors have found that in some patients, the disease can lead to hundreds of microclots in blood vessels, all of which can have a range of effects on the mother and developing baby.
“Right now we’re not doing enough. Maybe if people knew more about the risks they would be behaving differently,” she said, adding that she continues to have “lingering worries about what damage this may or may not have done” when it comes to future pregnancies since she and her husband would like to have more children.

(Source: Washington Post)

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