VINCENT DEPARTMENT OF OBSTETRICS AND GYNECOLOGY


COVID-19 in Pregnancy

When the COVID-19 pandemic erupted, the Vincent Department of Obstetrics and Gynecology at Massachusetts General Hospital recognized it had a job to do — to provide exceptional care to infected pregnant women and their babies. Our strong commitment to science and evidence-based medicine ideally positioned us to launch the “COVID-19 in Pregnancy” research program in 2020. Three investigational avenues are underway, powered by a team of dedicated front-line clinicians and laboratory scientists.

Mother-Baby Biology

Mother-Baby Biology

The Vincent Department of OB/GYN seeks to understand pregnant women’s immune response to COVID-19, the risk of transmission of the virus to babies, and how the maternal immune response and inflammation could potentially impact the developing fetus. This also is critical to understanding how pregnant women might respond to vaccines and therapies. To get answers, the department created the COVID-19 Biobank, an important resource created by faculty and fellows from our department, partnering with colleagues in Pediatrics and Infectious Disease. Our goal is to enroll 200 mother-baby pairs and study a variety of biospecimens collected throughout pregnancy and the postpartum period.

Principal Investigator
Andrea Edlow, MD, MSc
Investigator, Vincent Center for Reproductive Biology
Specialist in Maternal-Fetal Medicine, Vincent OB/GYN Division of Maternal-Fetal Medicine
Assistant Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School

Epidemiology and Outcomes

Epidemiology and Outcomes

Between March and July 2020, the Vincent team cared for more than 300 pregnant women with COVID-19. But how infection affects pregnant women’s health and the health of their offspring is relatively unknown because only small numbers of pregnant women and children with COVID-19 have been described in the world’s literature. Previous experience with other coronaviruses and influenza suggests pregnant women may be susceptible to more severe disease and adverse pregnancy outcomes, such as preterm delivery and stillbirth. We are establishing and following clinical cohorts to understand COVID-19’s impact on women’s health during pregnancy and their infants.

Principal Investigator
Adeline Boatin, MD, MPH
Obstetrician/Gynecologist, Vincent Department of OB/GYN
Assistant Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School
Affiliate Faculty, Program for Global Surgery and Social Change at Harvard Medical School and the Center for Global Health at Mass General

Pregnancy Experience During a Pandemic

Pregnancy Experience During a Pandemic

As the COVID-19 pandemic has introduced an unprecedented context of global uncertainty, including its impact on pregnant women, we have designed a qualitative study in which 60 patients will be asked to share their experience being pregnant during the pandemic and how this crisis has affected their pregnancy care and birth experience as well as their mental health, social support systems, economic security, food security and coping strategies. We also hope to identify racial and ethnic inequities related to COVID-19, which can help inform clinical protocols and interventions to support pregnant, delivering and postpartum women during the later stages of this and future pandemics.

Principal Investigator
Ilona Goldfarb, MD
Specialist in Maternal-Fetal Medicine, Vincent OB/GYN Division of Maternal-Fetal Medicine
Instructor in Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School
Associate Clerkship Director for OB/GYN, Director of Maternal-Fetal Medicine Sub-I, Harvard Medical School

What We've Learned So Far

What We've Learned So Far

To date, the Vincent Department of OB/GYN at Mass General has published the following articles on COVID-19 in professional journals (Vincent faculty and fellows in boldface). The expertise of Vincent OB/GYN faculty also is sought by the news media to inform the general public about COVID-19 (see Headline News).

Yonker LM, Neilan AM, Bartsch Y, Patel AB, Regan J, Arya P, Gootkind E, Park G, Hardcastle M, St John A, Appleman L, Chiu ML, Fialkowski A, De la Flor D, Lima R, Bordt EA, Yockey LJ, D’Avino P, Fischinger S, Shui JE, Lerou PH, Bonventre JV, Yu XG, Ryan ET, Bassett IV, Irimia D, Edlow AG, Alter G, Li JZ, Fasano A. Pediatric SARS-CoV-2: clinical presentation, infectivity, and immune responses. J Pediatrics (in press).

Shook L, Shui JE, MD, Boatin AA, Devane S, Natalie Croul N, Yonker LM, Matute JD, Lima RS, Schwinn M, Cvrk D, Gardner L, Azevedo R, Stanton S, Bordt EA, Yockey LJ, Fasano A, Li JZ, Yu XG, Kaimal AJ, Lerou PH, Edlow AG. Rapid establishment of a COVID-19 perinatal biorepository: early lessons from the first 100 women enrolled. BMC Med Res Method (in press).

Sawyer MR, Jaffe EF, Naqvi M, Sarma A, Barth WH Jr, Goldfarb IT.  Establishing better evidence on remote monitoring for postpartum hypertension: a silver lining of the coronavirus pandemic. Am J Perinatol Rept (in press).

Soffer M, Shook LL, James K, Sawyer MR, Ciaranello A, Mahrouk R, Bernstein SN, Boatin AA, Edlow AG, York-Best C, Kaimal AJ, Goldfarb IT. Outpatient management of pregnant patients with symptomatic COVID-19. Am J Perinatol (submitted for publication Aug 2020).

Duzyj CM, Thornburg LL, Han CS. Practice modification for pandemics: a model for surge planning in obstetrics. Obstet Gynecol. 2020 Aug;136(2):237–251. Epub 2020 Jun 02.

Goldfarb IT, Clapp MA, Soffer MD, Shook LL, Rushfirth K, Edlow AG, Boatin AA, Kaimal AJ, Barth WH Jr, Bryant AS. Prevalence and severity of coronavirus disease 2019 (COVID-19) illness in symptomatic pregnant and postpartum women stratified by Hispanic ethnicity. Obstet Gynecol. 2020 Aug;136(2):300–302. Epub 2020 Jun 02.

Duzyj Buniak C, Khachadoorian-Elia H, Berkowitz LR. The positives of the pause: lessons learned from the COVID-19 pandemic.ACOG Frontline Voices: Members stories from the COVID-19 pandemic. Epub 2020 May 26.

Kaimal A, Goldfarb I, Aurora M, Hanley L. How does SARS-CoV-2 change peri- and postpartum care?  FLARE 2020.