Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries [version 1; peer review: 1 approved, 1 approved with reservations]

Similar to previous outbreaks, the coronavirus disease 2019 (COVID19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in lowand middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.