Coronavirus Risk During Pregnancy

24-04-2020 | Posted in General News

With the current pandemic outbreak of Coronavirus (Covid-19), there is much concern of Coronavirus risk during Pregnancy, and that pregnant women may be at higher risk – both for themselves and for their unborn babies. Pregnant women, currently have been advised to take the same precautions as ordinary people – although to take extra care. There have been Coronavirus cases in both expectant mother and newborns and some good news stories of pregnant women and young babies having recovered from the virus, but there’s still a good amount of caution pregnant women and mothers with newborn babies should take to keep safe.

Why are pregnant women at higher risk for respiratory infections in general?

Let’s look at why there’s a higher risk factor for pregnant women. Even with the seasonal flu, pregnant women are more likely to get it than the general population and they’re at higher risk for more severe outcomes if they catch it. Similarly, in the H1N1 epidemic and the SARS epidemic, pregnant women were at higher risk for severe disease and death.

One reason is that pregnant women are in a more immuno-suppressed state. Decreased immune system defenses are a normal physiologic response so that the mother’s body doesn’t reject the pregnancy itself.
Also, the physical changes during pregnancy also compress the diaphragm and reduce lung volumes, so when there’s increased stress on the respiratory system, and have less backup to compensate for the increased work to breathe.

Pregnant women will have milder symptoms, but it also means that if a pregnant woman is symptomatic, she’s probably more sick than a non-pregnant person with the same symptoms.

Can Coronavirus be transmitted in utero, during birth, or through breastfeeding?

Based on cases with similar viruses, It is known that some viruses can be passed from mother to fetus in utero, including Zika, cytomegalovirus, rubella, and measles, and others during delivery, such as HIV, herpes and hepatitis – but respiratory viruses generally are not transmitted.

However an early study from China reported that out of 33 infants born to mothers with COVID-19, three tested positive days after birth, possibly through in utero transmission. Other studies have hinted at the possibility of in utero transmission based on elevated levels of certain antibodies, although the newborns tested negative for the virus.

All together, it’s too early for researchers to know the Coronavirus risk during Pregnancy and how transmissible COVID-19 is between mother and baby in utero, and also how the virus can affect a fetus. Some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were solely because of COVID-19.

Breastfeeding

So far, the virus has not been found in breast milk. But there is not enough information yet on whether women who are sick can pass the coronavirus through breast milk. Breast milk is the best source of nutrition for most babies, and also gives babies protection against many illnesses. Possibly talk with your midwife or other health care professional about whether to start or continue breastfeeding. You can make this decision together with your family and health care team.

As for breast pumps. Wash your hands before touching any breast pump or bottle parts and clean all pump and bottle parts after use. See the CDC’s advice for cleaning a breast pump.

What can pregnant women and parents of newborns do to stay safe?

Based on what we know from other respiratory illnesses pregnant women should be considered a high-risk group for COVID-19. That doesn’t mean they should lock themselves in their rooms for their whole pregnancy. In addition to the social distancing and hygiene precautions everyone should take, pregnant women are advised to talk to their doctor even if they have very mild symptoms. In particular, fevers should be controlled as quickly as possible because they may cause undue stress to the fetus. Prolonged fever in the first trimester, when organ systems are still forming, are more likely to harm fetal development and lead to birth defects or miscarriage.

But, while there’s a lot we don’t know about this disease, we do know actions we can take to avoid it. It is recommended pregnant women take the following precautions:

• Wash your hands frequently. You’ve heard this advice over and over (and over). But for good reason.
• Practice social distancing. Avoid contact with others unless you absolutely have to.
• Get the flu jab. It won’t protect you against COVID-19, but it will lower the risk of catching influenza, another more common respiratory illness that can cause complications for expectant mothers.
• Get Online. Whenever possible, consider online prenatal visits with your doctor instead of in-person appointments. Some visits will still need to be in-person, such as ultrasounds, fetal testing and some blood tests, but try to do as much online as possible.
• Call your doctor if you’re unwell. If you develop respiratory symptoms such as cough, fever or shortness of breath contact your doctor via telephone or e-visit. They can determine if you should be tested for the Coronavirus and what your next steps should be.

Pregnant women are advised to stay healthy by following the usual recommendations during pregnancy. Including: Eating healthy meals, Exercising regularly (though be mindful to stay at home or away from other people while exercising), getting plenty of rest and sleep, and avoiding alcohol and drugs.

It’s also a good idea to try to keep your mood balanced and keep anxiety to a minimal. Stress for expectant mother’s is not good, and certainly, some pregnant and postpartum women may be feeling fearful, uncertainty, stress, or anxiety because of COVID-19. So seek the support of your partner, friends and family to ease the extra burden and keep your mood positive and anxiety to a minimal.

Risk During Birth at the Hospital

Some expectant mothers are fearful of giving birth in hospital during the Coronavirus outbreak, with many considering home births. However, the general view of medical experts is that the safest place to give birth is still a hospital. The risks of complications are far greater than that of Coronavirus, so the hospital with medical staff is the best place to be.

Medical teams have lots of experience treating pregnant women who have the flu and other respiratory viruses, including SARS-CoV-1 and MERS-CoV. And hospitals have systems for dealing with respiratory diseases. They generally have plans in place for managing Coronavirus risk during Pregnancy, and pregnant women with symptoms of COVID-19 and to reduce exposure of newborns to the disease. As well as protecting healthy mothers and babies from Covid-19 exposure in the hospital from those patients being treated from the disease.

Your hospital or birth centre may have adjusted their policies. For example, there may be changes to the number of visitors allowed and how long you will stay in the hospital. It’s worth checking with your hospital or other health care professional about your birth plan. Nonetheless, giving birth in hospital is widely considered to be safe, and with minimal risk.

Real risk vs. Perceived risk

To conclude, all in all, the risk for pregnant women and babies in utero, and newborns is actually very low. However, it’s best to be well-informed during these times, and if you are expecting a baby, it’s best not to put yourself in harms way, and to take the necessary precautions. That way, you can shield yourself and your baby from the novel Coronavirus.

We hope this post on Coronavirus risk during Pregnancy has answered some of the questions of how the virus is affecting expectant mothers and newborn babies. Keep well and keep safe!

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