Maternal immune responses and obstetrical outcomes of pregnant women with COVID-19 and possible health risks of offspring

•Pregnant women with COVID-19 have proinflammatory immune responses.•Maternal COVID-19 is associated with increased risk of preterm birth, IUGR and LBW.•Vascular malperfusion, inflammation and thrombosis are major placental pathologies.•Placental pathologies may progress even in asymptomatic COVID-19 cases.•COVID-19 may increase long-term offspring risk for non-communicable disease. Coronavirus disease 2019 (COVID-19) pandemic has spread rapidly across the world. The vast majority of patients with COVID-19 manifest mild to moderate symptoms but may progress to severe cases or even mortalities. Young adults of reproductive age are the most affected population by SARS-CoV-2 infection. However, there is no consensus yet if pregnancy contributes to the severity of COVID-19. Initial studies of pregnant women have found that COVID-19 significantly increases the risk of preterm birth, intrauterine growth restriction, and low birth weight, which have been associated with non-communicable diseases in offspring. Besides, maternal viral infections with or without vertical transmission have been allied with neurological and behavioral disorders of the offspring. In this review, obstetrical outcomes of women with COVID-19 and possible risks for their offspring are discussed by reviewing maternal immune responses to COVID-19 based on the current evidence. Structural and systemic follow-up of offspring who are exposed to SARS-CoV-2 in-utero is suggested.