The COVID-19 pandemic is spreading across the globe and according to some estimates, 40-70% of people will be infected. This wide range shows that much depends on the steps we take to prevent the spread of infection.
For pregnant women, as for everyone, this is a sobering statistic. This suggests that we all need to do our part to stop the spread of COVID-19. There are also many things we can do to protect ourselves from infection: strict social distancing, hand washing, disinfecting high-touch surfaces, observing etiquette when coughing and sneezing, and leading a healthy lifestyle.
Even with these measures, some of us can get infected. Because data is so scarce, recommendations are still changing rapidly, and much more information is needed to understand the best ways to care for pregnant women and their children. Here’s what we know about COVID-19 infections during pregnancy.
What are the symptoms?
Typical symptoms are the same as most other people: hanging fever, cough, sore throat, muscle aches, fatigue, and shortness of breath. If you think you may be infected, it is very important that you report it to your doctor immediately. This is important not only for your own health and the health of your child, but also to protect medical staff and other women from infection.
Does COVID-19 increase the risk of complications and miscarriages?
With limited data, we can speculate what might happen based on our understanding of the complications of other respiratory infections. We know that a high temperature during the first trimester can cause birth defects in children. Flu infection has been linked to low birth weight and early birth. With SARS (a coronavirus in the same family as COVID-19, though much more deadly), there were risks of miscarriage, restricted baby growth, and early delivery. Pregnant women also faced more frequent hospitalizations. Based on the information we have access to, the risks do not appear to be as severe for COVID-19 infections.
From the few studies that have been published on COVID-19 in pregnant women, we know that those studied were in the third trimester and had mild to moderate infections (infections that did not need oxygen support before giving birth). However, it’s important to remember that we don’t know what will happen to pregnant women with conditions such as gestational diabetes, high blood pressure, or preeclampsia if they are also infected with COVID-19. We also don’t know what an infection in the first or second trimester might mean for the health of the mother or baby.
To date, the virus that causes COVID-19 has not been detected in the amniotic fluid (the fluid that surrounds a baby in the womb), in the umbilical cord blood, in the pharynx of babies, or in breast milk, so the risk of infecting babies in the uterine cavity is very low. Two new scientific reports presenting data from 7 newborns challenge this assumption. These reports showed that all 7 children had antibodies to the virus (probably from the mother), but 3 of the 7 had antibodies of a different type, which are usually too large to pass through the placenta from the mother, and could develop in children after exposure to the virus in the womb The data given here are not convincing, but give scientists another thread to continue observations.
What will happen during childbirth?
According to the American College of Obstetricians and Gynecologists, pregnant women with COVID-19 do not need to change the time or type of planned delivery. Much depends on their symptoms and other medical problems.
Some hospitals limit the number of people who can accompany pregnant women during childbirth, depending on the number of COVID-19 cases in the hospital, so this should also be prepared emotionally.
Recommendations on what to do after childbirth also vary from country to country. According to Chinese medical guidelines, newborns should be isolated from infected moms for 2 weeks (or until the mom is no longer considered infected.) The CDC recommends that hospitals “consider temporarily separating” moms and newborns. WHO recommends keeping mothers and children together. Since the virus is spread mainly through respiratory droplets, they advise mothers to follow strict hygiene and infection control measures, such as washing their hands and wearing a face mask, to minimize the impact of the virus on the baby.
Can I breastfeed my baby if I have a coronavirus infection?
Again, there is currently no evidence that the virus can be found in breast milk, so breast milk should be safe to feed newborns. Right now, since the recommendation is to separate newborns from moms who have COVID-19, this may mean that the baby should be kept in a separate room or at least 2 meters away from the mom after giving birth.
It is very important to prevent infection of newborns. While early information from China has been encouraging, we still don’t know enough about how the disease might affect them.
Again, all the data we have at the moment is taken from small studies, so we just don’t know enough about the risks to pregnant women and their babies yet. This is especially true when it comes to the risks depending on which trimester the mother is infected.
The most important thing we can do to protect ourselves and our unborn children is to prevent infection. If we become infected (or suspect that we are infected), we should immediately report it to medical professionals. This allows you to get the necessary medical care, and also prevents the spread of infection among others.