SOMANZ Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Fatigue and fertility: the emerging challenge of navigating pregnancy with long COVID (#184)

Sagun Banjade 1 2 , Naomi Whyler 2 3 4 , Emma Tippett 2 5
  1. Flinders Medical Centre, Adelaide, South Australia, Australia
  2. Clinic Nineteen Telehealth Clinic, Melbourne, Victoria, Australia
  3. Department of Obstetrics, Monash University, Melbourne, Victoria, Australia
  4. Department of Obstetric Medicine, Joan Kirner Women & Children's Hospital, Melbourne, Victoria, Australia
  5. Burnet Institute, Melbourne, Victoria, Australia

Background:

Long COVID (LC) is a recently recognised post-viral condition occurring after SARS-CoV-2 infection, disproportionately affecting women of childbearing age1. Immune and vascular dysfunction in LC is characterised by fatigue, post-exertional malaise, sleep disorder, new-onset dysautonomia including Postural Orthostatic Tachycardia Syndrome (POTS), headaches, pain, gastrointestinal symptoms, many of which overlap with normal pregnancy symptoms1. As LC prevalence rises, maternity care providers must be equipped to support this growing patient population. 2,3.

Aims / Clinical:

We present a pilot clinical tool to support maternity care providers managing patients with LC, based on our clinical experience at a dedicated LC clinic which has provided care to over 1000 patients to date, with many seeking preconception advice.

Women with preexisting LC face complex decisions around pregnancy timing, medication adjustment due to teratogenicity concerns, COVID vaccination, and risks of symptom relapse —for example, exacerbation of POTS with hyperemesis gravidarum. Postpartum care also requires special attention to fatigue and dysautonomia management.

We illustrate the use of our tool with the case of a 23-year-old woman attending maternity services, experiencing severe LC following acute COVID-19 infection in 2021. Her pregnancy challenges mostly involved worsened orthostatic intolerance as pregnancy progressed. Management involved exclusion of alternative diagnoses and cautious titration of both pharmacological and non-pharmacological therapies, each requiring unique consideration in pregnancy.

Conclusion:

LC presents novel challenges in maternity care. Clinical tools and structured checklists can support maternity care providers by improving awareness, minimising harm, and addressing both the medical and psychological needs of women with Long COVID.

  1. 1. Greenhalgh T, Sivan M, Perlowski A, Nikolich JZ. Long COVID: a clinical update. Lancet 2024; 404:10453.
  2. 2. Georgakopoulou VE, Taskou C, Spandidos DA, Sarantaki A. Long COVID-19 and pregnancy: a systematic review. Biomed Rep. 2024; 22(1):15.
  3. 3. Maisonneuve E, Favre G, Boucoiran I, Dashraath P, Panchaud A, Baud D. Post-COVID-19 condition : recommendations for pregnant individuals. Lancet Reg Health Eur. 2024; 40:100916.