Publication:

Maternal and neonatal biochemical sequelae following prenatal COVID-19 infection: evidence across the peripartum period

Pregnancy is characterized by dynamic physiological, immunological, and biochemical adaptations that sustain foetal growth and maternal health. Viral infections such as COVID-19 can disrupt this equilibrium, provoking systemic inflammatory, metabolic, and coagulative responses. While clinical complications of prenatal SARS-CoV-2 infection have been widely described, evidence on biochemical sequelae across pregnancy, delivery, and postpartum remains fragmented. Therefore, this scoping review aims to map published evidence on maternal, placental, and neonatal biochemical markers following prenatal COVID-19 infection across the peripartum period. Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, Google Scholar, and Epistemonikos from January 2020 to March 2025. Observational studies examining biochemical or immunological markers among COVID-19 infected pregnant women and their offspring were included. Data were extracted using a pre-tested charting tool and narratively synthesized during pregnancy, at delivery, and postpartum. Twenty-seven studies met inclusion criteria. Elevated inflammatory, and haematological markers were consistently observed during pregnancy. Neonatal respiratory distress and multisystem inflammatory manifestations were associated with elevated inflammatory markers. Postpartum evidence suggested presence of immunoglobulins in breast milk, thus providing passive neonatal protection. Expression of placental ACE2 and TMPRSS2 suggested viral entry expression, aligning with limited evidence of vertical transmission. Prenatal COVID-19 infection led to a wide spectrum of biochemical alterations in maternal and neonatal systems. However, emerging evidence remains heterogeneous and limited beyond delivery, hence underscoring the need for longitudinal biochemical surveillance across the peripartum period.