Geburtshilfe Frauenheilkd 2023; 83(05): 517-546
DOI: 10.1055/a-2003-5983
GebFra Science

SARS-CoV-2 in Pregnancy, Birth and Puerperium. Guideline of the DGGG and DGPM (S2k-Level, AWMF Registry Number 015/092, March 2022)

Article in several languages: deutsch | English
Ulrich Pecks
1   Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
Lena Agel
2   Technische Hochschule Aschaffenburg, Hebammenkunde, Aschaffenburg, Germany
Klaus J. Doubek
3   Praxis Doubek, Wiesbaden, Germany
Carsten Hagenbeck
4   Geburtshilfe und Perinatalmedizin, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
Lukas Jennewein
5   Geburtshilfe und Pränatalmedizin, Universitätsklinikum Frankfurt Goethe-Universität, Frankfurt am Main, Germany
Constantin von Kaisenberg
6   Pränatalmedizin und Geburtshilfe im Perinatalzentrum, Universitätsklinik der Medizinischen Hochschule Hannover, Hannover, Germany
Peter Kranke
7   Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Würzburg, Germany
Sabine Leitner
8   Bundesverband „Das frühgeborene Kind“ e. V., Frankfurt, Germany
Nadine Mand
9   Philipps-Universität Marburg, Zentrum für Kinder- und Jugendmedizin, Marburg, Germany
Mario Rüdiger
10   Klinik für Kinder- und Jugendmedizin, Fachbereich Neonatologie und pädiatrische Intensivmedizin, Medizinische Fakultät der TU Dresden, Dresden, Germany
Janine Zöllkau
11   Klinik für Geburtsmedizin, Universitätsklinikum Jena, Jena, Germany
Nina Mingers
1   Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
Magdalena Sitter
7   Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Würzburg, Germany
Frank Louwen
5   Geburtshilfe und Pränatalmedizin, Universitätsklinikum Frankfurt Goethe-Universität, Frankfurt am Main, Germany
› Author Affiliations


Objective This S2k guideline of the German Society for Gynecology and Obstetrics (DGGG) and the German Society of Perinatal Medicine (DGPM) contains consensus-based recommendations for the care and treatment of pregnant women, parturient women, women who have recently given birth, and breastfeeding women with SARS-CoV-2 infection and their newborn infants. The aim of the guideline is to provide recommendations for action in the time of the COVID-19 pandemic for professionals caring for the above-listed groups of people.

Methods The PICO format was used to develop specific questions. A systematic targeted search of the literature was carried out using PubMed, and previously formulated statements and recommendations issued by the DGGG and the DGPM were used to summarize the evidence. This guideline also drew on research data from the CRONOS registry. As the data basis was insufficient for a purely evidence-based guideline, the guideline was compiled using an S2k-level consensus-based process. After summarizing and presenting the available data, the guideline authors drafted recommendations in response to the formulated PICO questions, which were then discussed and voted on.

Recommendations Recommendations on hygiene measures, prevention measures and care during pregnancy, delivery, the puerperium and while breastfeeding were prepared. They also included aspects relating to the monitoring of mother and child during and after infection with COVID-19, indications for thrombosis prophylaxis, caring for women with COVID-19 while they are giving birth, the presence of birth companions, postnatal care, and testing and monitoring the neonate during rooming-in or on the pediatric ward.

Publication History

Received: 08 December 2022

Accepted: 14 December 2022

Article published online:
09 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Blankenfeld H, Kaduszkiewicz H, Kochen MM. et al. AWMF 053/054. SARS-CoV-2/Covid-19 Informationen und Praxishilfen für niedergelassene Hausärztinnen und Hausärzte. 2022. Accessed February 23, 2022 at:
  • 2 Kluge S, Janssens U, Welte T. et al. AWMF 113/001. Empfehlungen zur stationären Therapie von Patienten mit COVID-19 – Living Guideline. 2021. Accessed February 23, 2022 at:
  • 3 Zöllkau J, Hagenbeck C, Hecher K. et al. [Recommendations for SARS-CoV-2/COVID-19 during Pregnancy, Birth and Childbed – Update November 2021 (Long Version)]. Z Geburtshilfe Neonatol 2022; 226: e1-e35
  • 4 Rossi R, Bauer NH, Becke-Jakob K. et al. AWMF 087/001. Empfehlungen für die strukturellen Voraussetzungen der perinatologischen Versorgung in Deutschland. 2021. Accessed March 06, 2022 at:
  • 5 von der Wense A, Roll C, Maier RF. et al. AWMF 024/002. Verlegung von Früh- und Reifgeborenen in Krankenhäuser der adäquaten Versorgungsstufe. 2019. Accessed March 06, 2022 at:
  • 6 Janssens U, Schlitt A, Hein A. et al. AWMF 040/015. SARS-CoV-2 Infektion bei Mitarbeiterinnen und Mitarbeitern im Gesundheitswesen – Bedeutung der RT-PCR Testung. 2020. Accessed February 23, 2022 at:
  • 7 Mattner F. AWMF 067/010. Infektionsprävention durch das Tragen von Masken. 2020. Accessed February 23, 2022 at:
  • 8 Chu DK, Akl EA, Duda S. et al. COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395: 1973-1987
  • 9 Chan VWS, Ng HHL, Rahman L. et al. Transmission of Severe Acute Respiratory Syndrome Coronavirus 1 and Severe Acute Respiratory Syndrome Coronavirus 2 During Aerosol-Generating Procedures in Critical Care: A Systematic Review and Meta-Analysis of Observational Studies. Crit Care Med 2021; 49: 1159-1168
  • 10 Riley J, Huntley JM, Miller JA. et al. Mask Effectiveness for Preventing Secondary Cases of COVID-19, Johnson County, Iowa, USA. Emerg Infect Dis 2022; 28: 69-75
  • 11 Hein A, Kehl S, Häberle L. et al. Prevalence of SARS-CoV-2 in Pregnant Women Assessed by RT-PCR in Franconia, Germany: First Results of the SCENARIO Study (SARS-CoV-2 prEvalence in pregNAncy and at biRth InFrancOnia). Geburtshilfe Frauenheilkd 2022; 82: 226-234
  • 12 RKI. RKI – Infektionskrankheiten A–Z – COVID-19 (Coronavirus SARS-CoV-2). 2021. Accessed February 23, 2022 at:
  • 13 Sitter M, Pecks U, Rüdiger M. et al. Pregnant and Postpartum Women Requiring Intensive Care Treatment for COVID-19-First Data from the CRONOS-Registry. J Clin Med 2022; 11: 701
  • 14 Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-1242
  • 15 Knight M, Bunch K, Vousden N. et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ 2020; 369: m2107
  • 16 Danielsen AS, Cyr PR, Magnus MC. et al. Birthing parents had a lower risk of testing positive for SARS-CoV-2 in the peripartum period in Norway, 15th of February 2020 to 15th of May 2021. Infect Prev Pract 2021; 3: 100183
  • 17 Docherty AB, Harrison EM, Green CA. et al. ISARIC4C investigators. Features of 20133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 2020; 369: m1985
  • 18 Stanczyk P, Jachymski T, Sieroszewski P. COVID-19 during pregnancy, delivery and postpartum period based on EBM. Ginekol Pol 2020; 91: 417-423
  • 19 Selim M, Mohamed S, Abdo M. et al. Is COVID-19 Similar in Pregnant and Non-Pregnant Women?. Cureus 2020; 12: e8888
  • 20 Wenling Y, Junchao Q, Zhirong X. et al. Pregnancy and COVID-19: management and challenges. Rev Inst Med Trop Sao Paulo 2020; 62: 1-9
  • 21 Thompson JL, Nguyen LM, Noble KN. et al. COVID-19-related disease severity in pregnancy. Am J Reprod Immunol 2020; 84: e13339
  • 22 Molteni E, Astley CM, Ma W. et al. SARS-CoV-2 (COVID-19) infection in pregnant women: characterization of symptoms and syndromes predictive of disease and severity through real-time, remote participatory epidemiology. medRxiv [Preprint] 2020; DOI: 10.1101/2020.08.17.20161760.
  • 23 Pettirosso E, Giles M, Cole S. et al. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol 2020; 60: 640-659
  • 24 Hanna N, Hanna M, Sharma S. Is pregnancy an immunological contributor to severe or controlled COVID-19 disease?. Am J Reprod Immunol 2020; 84: e13317
  • 25 Blitz MJ, Rochelson B, Prasannan L. et al. Racial and ethnic disparity and spatiotemporal trends in severe acute respiratory syndrome coronavirus 2 prevalence on obstetrical units in New York. Am J Obstet Gynecol MFM 2020; 2: 100212
  • 26 Emeruwa UN, Spiegelman J, Ona S. et al. Influence of Race and Ethnicity on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Rates and Clinical Outcomes in Pregnancy. Obstet Gynecol 2020; 136: 1040-1043
  • 27 Flannery DD, Gouma S, Dhudasia MB. et al. SARS-CoV-2 seroprevalence among parturient women in Philadelphia. Sci Immunol 2020; 5: eabd5709
  • 28 Ellington S, Strid P, Tong VT. et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status – United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 769-775
  • 29 Moore JT, Ricaldi JN, Rose CE. et al. Disparities in Incidence of COVID-19 Among Underrepresented Racial/Ethnic Groups in Counties Identified as Hotspots During June 5–18, 2020–22 States, February–June 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 1122-1126
  • 30 Zambrano LD, Ellington S, Strid P. et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status – United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 1641-1647
  • 31 Prasannan L, Rochelson B, Shan W. et al. Social determinants of health and coronavirus disease 2019 in pregnancy. Am J Obstet Gynecol MFM 2021; 3: 100349
  • 32 Haizler-Cohen L, Moncada K, Collins A. et al. 611 Racial, ethnic and socioeconomic disparities in susceptibility to SARS-CoV-2 in pregnancy. Am J Obstet Gynecol 2021; 224: S383
  • 33 Gurol-Urganci I, Jardine JE, Carroll F. et al. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study. Am J Obstet Gynecol 2021; 225: 522.e1-522.e11
  • 34 Di Mascio D, Sen C, Saccone G. et al. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. J Perinat Med 2020; 48: 950-958
  • 35 Sahu AK, Sreepadmanabh M, Rai M. et al. SARS-CoV-2: phylogenetic origins, pathogenesis, modes of transmission, and the potential role of nanotechnology. Virusdisease 2021; 32: 1-12
  • 36 Vousden N, Bunch K, Morris E. et al. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS). PLoS One 2021; 16: e0251123
  • 37 Pecks U, Kuschel B, Mense L. et al. Pregnancy and SARS-CoV-2 Infection in Germany-the CRONOS Registry. Dtsch Arztebl Int 2020; 117: 841-842
  • 38 Sutton D, Fuchs K, DʼAlton M. et al. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med 2020; 382: 2163-2164
  • 39 Khalil A, Hill R, Ladhani S. et al. Severe acute respiratory syndrome coronavirus 2 in pregnancy: symptomatic pregnant women are only the tip of the iceberg. Am J Obstet Gynecol 2020; 223: 296-297
  • 40 Campbell KH, Tornatore JM, Lawrence KE. et al. Prevalence of SARS-CoV-2 Among Patients Admitted for Childbirth in Southern Connecticut. JAMA 2020; 323: 2520-2522
  • 41 Donders F, Lonnée-Hoffmann R, Tsiakalos A. et al. ISIDOG Recommendations Concerning COVID-19 and Pregnancy. Diagnostics 2020; 10: 243
  • 42 Koczulla AR, Ankermann T, Gogoll C. et al. AWMF 067/010. S1-Leitlinie Post-COVID/Long-COVID. Accessed February 23, 2022 at:
  • 43 G-BA. Richtlinien des Gemeinsamen Bundesausschusses über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung („Mutterschafts-Richtlinien“). 2022. Accessed February 23, 2022 at:
  • 44 Schlembach D, Stepan H. für die Leitlinienkommission. AWMF 015/018. Hypertensive Schwangerschaftserkrankungen. Diagnostik und Therapie 2019; 1-117 Accessed February 23, 2022 at:
  • 45 Louwen F, Wagner U, Abou-Dakn M. et al. Caesarean Section. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/084, June 2020). Geburtshilfe Frauenheilkd 2021; 81: 896-921
  • 46 Abou-Dakn M, Schäfers R, Peterwerth N. et al. Vaginal Birth at Term – Part 1. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/083, December 2020). Geburtshilfe Frauenheilkd 2022; 82: 1143-1193
  • 47 Kehl S, Dötsch J, Hecher K. et al. Intrauterine Growth Restriction. Guideline of the German Society of Gynecology and Obstetrics (S2k-Level, AWMF Registry No. 015/080, October 2016). Geburtshilfe Frauenheilkd 2017; 77: 1157-1173
  • 48 Berger R, Abele H, Bahlmann F. et al. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 1 with Recommendations on the Epidemiology, Etiology, Prediction, Primary and Secondary Prevention of Preterm Birth. Geburtshilfe Frauenheilkd 2019; 79: 800-812
  • 49 KBV; BÄK, GBW. Influenzapandemie Risikomanagement in Arztpraxen. 2008. Accessed February 23, 2022 at:
  • 50 Rempen A, Chaoui R, Häusler M. et al. Quality Requirements for Ultrasound Examination in Early Pregnancy (DEGUM Level I) between 4 + 0 and 13 + 6 Weeks of Gestation. Ultraschall Med 2016; 37: 579-583
  • 51 Kozlowski P, Burkhardt T, Gembruch U. et al. DEGUM, ÖGUM, SGUM and FMF Germany Recommendations for the Implementation of First-Trimester Screening, Detailed Ultrasound, Cell-Free DNA Screening and Diagnostic Procedures. Ultraschall Med 2019; 40: 176-193
  • 52 von Kaisenberg C, Klaritsch P, Ochsenbein-Kölble N. et al. Screening, Management and Delivery in Twin Pregnancy. Ultraschall Med 2021; 42: 367-378
  • 53 Von Kaisenberg C, Chaoui R, Häusler M. et al. Quality Requirements for the early Fetal Ultrasound Assessment at 11–13 + 6 Weeks of Gestation (DEGUM Levels II and III). Ultraschall Med 2016; 37: 297-302
  • 54 Merz E, Eichhorn KH, Von Kaisenberg C. et al. Aktualisierte Qualitätsanforderungen an die weiterführende differenzierte Ultraschalluntersuchung in der pränatalen Diagnostik (= DEGUM-Stufe II) im Zeitraum von 18 + 0 bis 21 + 6 Schwangerschaftswochen. Ultraschall Med 2012; 33: 593-596
  • 55 Chaoui R, Heling K, Mielke G. et al. [Quality standards of the DEGUM for performance of fetal echocardiography]. Ultraschall Med 2008; 29: 197-200
  • 56 Faber R, Heling KS, Steiner H. et al. [Doppler Sonography during Pregnancy – DEGUM Quality Standards and Clinical Applications]. Ultraschall Med 2019; 40: 319-325
  • 57 Faber R, Heling KS, Steiner H. et al. Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2). Ultraschall Med 2021; 42: 541-550
  • 58 Kleinwechter H, Groten T, Schäfer-Graf U. et al. COVID-19 and pregnancy: Case series with diabetes co-morbidity from the registry study ‘Covid-19 Related Obstetric and Neonatal Outcome Study’ (CRONOS). Diabetologe 2021; 17: 88-94
  • 59 Machluf Y, Rosenfeld S, Ben Shlomo I. et al. The Misattributed and Silent Causes of Poor COVID-19 Outcomes Among Pregnant Women. Front Med 2021; 8: 1902
  • 60 Düppers AL, Bohnhorst B, Bültmann E. et al. Severe fetal brain damage subsequent to acute maternal hypoxemic deterioration in COVID-19. Ultrasound Obstet Gynecol 2021; 58: 490-491
  • 61 Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow?. Acta Obstet Gynecol Scand 2020; 99: 439-442
  • 62 Rasmussen SA, Smulian JC, Lednicky JA. et al. Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol 2020; 222: 415-426
  • 63 RCOG. Coronavirus (COVID-19) infection and pregnancy. 2022. Accessed February 27, 2022 at:
  • 64 Antoun L, Taweel NE, Ahmed I. et al. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol 2020; 252: 559-562
  • 65 Diriba K, Awulachew E, Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res 2020; 25: 39
  • 66 Ahlberg M, Neovius M, Saltvedt S. et al. Association of SARS-CoV-2 Test Status and Pregnancy Outcomes. JAMA 2020; 324: 1782-1785
  • 67 Papageorghiou AT, Deruelle P, Gunier RB. et al. Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study. Am J Obstet Gynecol 2021; 225: 289.e1-289.e17
  • 68 Wei SQ, Bilodeau-Bertrand M, Liu S. et al. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021; 193: E540-E548
  • 69 Villar J, Ariff S, Gunier RB. et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr 2021; 175: 817-826
  • 70 Pirkle CM. Evidence based care for pregnant women with covid-19. BMJ 2020; 370: m3510
  • 71 Jafari M, Pormohammad A, Sheikh Neshin SA. et al. Clinical characteristics and outcomes of pregnant women with COVID-19 and comparison with control patients: A systematic review and meta-analysis. Rev Med Virol 2021; 31: 1-16
  • 72 Allotey J, Stallings E, Bonet M. et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370: m3320
  • 73 Khalil A, Kalafat E, Benlioglu C. et al. SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. EClinicalMedicine 2020; 25: 100446
  • 74 Martinez-Perez O, Prats Rodriguez P, Muner Hernandez M. et al. Spanish Obstetric Emergency Group. The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis. BMC Pregnancy Childbirth 2021; 21: 273
  • 75 Stock SJ, Carruthers J, Calvert C. et al. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland. Nat Med 2022; 28: 504-512
  • 76 Radan AP, Baud D, Favre G. et al. Low placental weight and altered metabolic scaling after severe acute respiratory syndrome coronavirus type 2 infection during pregnancy: a prospective multicentric study. Clin Microbiol Infect 2022; 28: 718-722
  • 77 Prabhu M, Cagino K, Matthews KC. et al. Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study. BJOG 2020; 127: 1548-1556
  • 78 Kirtsman M, Diambomba Y, Poutanen SM. et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. CMAJ 2020; 192: E647-E650
  • 79 Mulvey JJ, Magro CM, Ma LX. et al. Analysis of complement deposition and viral RNA in placentas of COVID-19 patients. Ann Diagn Pathol 2020; 46: 151530
  • 80 Smithgall MC, Liu-Jarin X, Hamele-Bena D. et al. Third-trimester placentas of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive women: histomorphology, including viral immunohistochemistry and in-situ hybridization. Histopathology 2020; 77: 994-999
  • 81 Gulersen M, Prasannan L, Tam Tam H. et al. Histopathologic evaluation of placentas after diagnosis of maternal severe acute respiratory syndrome coronavirus 2 infection. Am J Obstet Gynecol MFM 2020; 2: 100211
  • 82 WHO. Definition and categorization of the timing of mother-to-child transmission of SARS-CoV-2. 2021. Accessed March 02, 2022 at:
  • 83 Gengler C, Dubruc E, Favre G. et al. SARS-CoV-2 ACE-receptor detection in the placenta throughout pregnancy. Clin Microbiol Infect 2021; 27: 489
  • 84 Andersson MI, Arancibia-Carcamo CV, Auckland K. et al. SARS-CoV-2 RNA detected in blood products from patients with COVID-19 is not associated with infectious virus. Wellcome Open Res 2020; 5: 181
  • 85 Vivanti AJ, Vauloup-Fellous C, Prevot S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 2020; 11: 3572
  • 86 Raschetti R, Vivanti AJ, Vauloup-Fellous C. et al. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nat Commun 2020; 11: 5164
  • 87 Longardt AC, Winkler VP, Pecks U. SARS-CoV-2 and Perinatal Aspects. Z Geburtshilfe Neonatol 2020; 224: 181-186
  • 88 Aebi C. Steckbrief COVID-19 – klinische Besonderheiten bei Kindern und Jugendlichen. 2020. Accessed at:
  • 89 Mand N, Iannaccone A, Longardt AC. et al. CRONOS Network; CRONOS-Network. Neonatal outcome following maternal infection with SARS-CoV-2 in Germany: COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS). Arch Dis Child Fetal Neonatal Ed 2022; 107: 454-456
  • 90 Woodworth KR, Olsen EO, Neelam V. et al. Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy – SET-NET, 16 Jurisdictions, March 29-October 14, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 1635-1640
  • 91 DGPI. Stellungnahme der DGPI im Einvernehmen mit der DGGG und der DGPM: Umgang mit Neugeborenen SARS-CoV-2 positiver Mütter (Stand 31.03.2020). 2020. Accessed March 05, 2022 at:
  • 92 Nationale Stillkommission. Stillen-COVID-19 | Max Rubner-Institut. 2020. Accessed March 05, 2022 at:
  • 93 Gale C, Quigley MA, Placzek A. et al. Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance. Lancet Child Adolesc Heal 2021; 5: 113-121
  • 94 Martenot A, Labbassi I, Delfils-Stern A. et al. Favorable outcomes among neonates not separated from their symptomatic SARS-CoV-2-infected mothers. Pediatr Res 2020; 90: 8-11
  • 95 CDC. Caring for Newborns | COVID-19 | CDC. 2020. Accessed March 03, 2022 at:
  • 96 Ronchi A, Pietrasanta C, Zavattoni M. et al. Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy. JAMA Pediatr 2021; 175: 260-266
  • 97 Salvatore CM, Han JY, Acker KP. et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study. Lancet Child Adolesc Heal 2020; 4: 721-727
  • 98 Auriti C, De Rose DU, Mondì V. et al. On Behalf Of The Study Group Of Neonatal Infectious Diseases. Neonatal SARS-CoV-2 Infection: Practical Tips. Pathogens 2021; 10: 611
  • 99 Wang L, Shi Y, Xiao T. et al. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Ann Transl Med 2020; 8: 47-47
  • 100 RCOG. Thrombosis and Embolism during Pregnancy and the Puerperium, Reducing the Risk (Green-top Guideline No. 37a). 2015. Accessed March 12, 2022 at:
  • 101 Parunov LA, Soshitova NP, Ovanesov MV. et al. Epidemiology of venous thromboembolism (VTE) associated with pregnancy. Birth Defects Res C Embryo Today 2015; 105: 167-184
  • 102 Pomp ER, Lenselink AM, Rosendaal FR. et al. Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study. J Thromb Haemost 2008; 6: 632-637
  • 103 Bongiovanni D, Klug M, Lazareva O. et al. SARS-CoV-2 infection is associated with a pro-thrombotic platelet phenotype. Cell Death Dis 2021; 12: 50
  • 104 Perico L, Benigni A, Casiraghi F. et al. Immunity, endothelial injury and complement-induced coagulopathy in COVID-19. Nat Rev Nephrol 2021; 17: 46-64
  • 105 Jering KS, Claggett BL, Cunningham JW. et al. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. JAMA Intern Med 2021; 181: 714-717
  • 106 Servante J, Swallow G, Thornton JG. et al. Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis. BMC Pregnancy Childbirth 2021; 21: 108
  • 107 DʼSouza R, Malhamé I, Teshler L. et al. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19. Acta Obstet Gynecol Scand 2020; 99: 1110-1120
  • 108 Bikdeli B, Madhavan MV, Jimenez D. et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75: 2950-2973
  • 109 Wörmann B. Kommission „Nutzenbewertung von Arzneimitteln“ unter Einbindung der AG Therapie des STAKOB. Antivirale Arzneimittel zur Therapie von COVID-19. 2022. Accessed April 20, 2022 at:
  • 110 Wörmann B; Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger (STAKOB), Fachgruppe Intensivmedizin, Infektiologie und Notfallmedizin (COVRIIN) des Robert-Koch-Instituts. COVID-19 Präexpositionsprophylaxe. Accessed April 20, 2022 at:
  • 111 WHO. Therapeutics and COVID-19: living guideline. 2022. Accessed March 06, 2022 at:
  • 112 Chambers CD, Johnson DL, Xu R. et al. Birth outcomes in women who have taken adalimumab in pregnancy: A prospective cohort study. PLoS One 2019; 14: e0223603
  • 113 Puchner A, Gröchenig HP, Sautner J. et al. Immunosuppressives and biologics during pregnancy and lactation : A consensus report issued by the Austrian Societies of Gastroenterology and Hepatology and Rheumatology and Rehabilitation. Wien Klin Wochenschr 2019; 131: 29-44
  • 114 RECOVERY Collaborative Group. Horby PW, Mafham M. et al. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. MedRxiv 2021; DOI: 10.1101/2021.06.15.21258542.
  • 115 Zöllkau J, Reuken PA, Schleußner E. et al. Monoclonal SARS-CoV-2 Antibodies in Pregnancy-a Case Series. Dtsch Arztebl Int 2022; 119: 113-114
  • 116 FDA. FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR EVUSHELD™ (tixagevimab co-packaged with cilgavimab) HIGHLIGHTS OF EMERGENCY USE AUTHORIZATION (EUA) These highlights of the EUA do not include all the information needed to use EVUSHELD™. 2022. Accessed March 06, 2022 at:
  • 117 EMA. ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS Tixagevimab/Cilgavimab, 2022. Accessed March 06, 2022 at:
  • 118 Burwick RM, Yawetz S, Stephenson KE. et al. Compassionate Use of Remdesivir in Pregnant Women With Severe Coronavirus Disease 2019. Clin Infect Dis 2021; 73: e3996-e4004
  • 119 Beigel JH, Tomashek KM, Dodd LE. et al. Remdesivir for the Treatment of Covid-19 – Final Report. N Engl J Med 2020; 383: 1813-1826
  • 120 Cavalcante MB, Cavalcante CTDMB, Braga ACS. et al. COVID-19 Treatment: Drug Safety Prior to Conception and during Pregnancy and Breastfeeding. Geburtshilfe Frauenheilkd 2021; 81: 46-60
  • 121 Jiménez-Lozano I, Caro-Teller JM, Fernández-Hidalgo N. et al. Safety of tocilizumab in COVID-19 pregnant women and their newborn: A retrospective study. J Clin Pharm Ther 2021; 46: 1062-1070
  • 122 Liu D, Zhang T, Wang Y. et al. Tocilizumab: The Key to Stop Coronavirus Disease 2019 (COVID-19)-Induced Cytokine Release Syndrome (CRS)?. Front Med (Lausanne) 2020; 7: 571597
  • 123 Hoeltzenbein M, Beck E, Rajwanshi R. et al. Tocilizumab use in pregnancy: Analysis of a global safety database including data from clinical trials and post-marketing data. Semin Arthritis Rheum 2016; 46: 238-245
  • 124 EMA. EMA issues advice on use of Paxlovid (PF-07321332 and ritonavir) for the treatment of COVID-19: rolling review starts in parallel | European Medicines Agency. 2022. Accessed April 20, 2022 at:
  • 125 Elsevier – Drug Monograph. Elsevier – Drug Monograph | Nirmatrelvir; Ritonavir. 2022. Accessed April 20, 2022 at:
  • 126 Pecks U. Booster-Impfung für schwangere und stillende Frauen. 2021. Accessed March 06, 2022 at:
  • 127 RKI. RKI – Impfen – Impfung bei Schwangeren, Stillenden und bei Kinderwunsch (Stand: 15.2.2022). 2022. Accessed March 06, 2022 at:
  • 128 Takla A, Matysiak-Klose D, Bogdan C. et al. Empfehlung und Begründung der STIKO zur Impfung gegen COVID-19 von Schwangeren und Stillenden. Epidemiol Bull 2021; 38: 10-36