What Pregnant People Need to Know About Coronavirus
Does COVID-19 affect pregnant women more severely? We spoke with experts to learn more about the potential impact of the coronavirus on your pregnancy.
The new coronavirus (COVID-19) has caused widespread panic since it originated in Wuhan, China, a few months ago. But while the disease has caused at least 5,472,400 illnesses and 345,800 deaths worldwide, it's still early for researchers to know exactly how COVID-19 impacts pregnant women or fetuses. Pregnant women might be at a higher risk, but experts believe that the coronavirus doesn’t pass from Mother to Baby through the placenta. One small study published in JAMA Pediatrics on March 26, however, suggests that infected mothers may pass the coronavirus onto their babies, though it's unclear if that happens in the womb or during delivery. Read on for more information about COVID-19 and pregnancy, with tips for preventing the fast-spreading respiratory illness.
Coronavirus and Pregnancy
It’s natural for pregnant women to worry about the coronavirus. After all, they have a higher risk of contracting viral illnesses due to changes in physiology and immune systems, according to Jessica Madden, M.D., medical director of Aeroflow Breastpumps. “For example, women who get influenza while pregnant are at a higher risk of developing pneumonia than women who aren't pregnant,” she says. Viral illnesses like the flu are associated with an increased risk for miscarriages, birth defects, low birth weight, and other pregnancy complications.
Scientists don’t know whether COVID-19 follows this same trend, but preliminary research suggests otherwise. A report from the World Health Organization-China Joint Mission, published in mid-February 2020, investigated 147 pregnant women with the coronavirus. Researchers found that 8 percent of cases were considered “severe” and 1 percent were “critical.” These numbers seem comparable with statistics for non-pregnant people.
However, Dr. Madden and the CDC stress that more information is needed before making a definite conclusion. This is especially true since two other coronaviruses—SARS and MERS, which caused outbreaks in the past—were associated with more severe illness and greater mortality in pregnant women.
According to Justin Brandt, M.D., an assistant professor of obstetrics and gynecology in the Division of Maternal-Fetal Medicine at Rutgers Robert Wood Medical School in New Jersey, "women with COVID-19 might be at greater risk for pregnancy complications. The American College of Obstetricians and Gynecologists and the National Health Service from Great Britain are concerned that women might be more prone to miscarriage, preterm birth, and fetal growth restriction if they have COVID-19."
Also keep in mind that the coronavirus tends to affect older people and those with preexisting conditions more severely, according to the CDC. It makes sense, then, that those with “high-risk” pregnancies have increased odds, suggests Dr. Madden. This includes women with preeclampsia, gestational diabetes, and other complications.
Does Coronavirus Affect the Fetus?
Here’s a piece of good news for pregnant women: Preliminary research published in The Lancet suggests that COVID-19 doesn’t pass through the placenta (intrauterine vertical transmission). The study followed nine women who gave birth via C-section, and found that none of the babies tested positive for the coronavirus. They also appeared healthy after birth. “To date, all umbilical cord blood, amniotic fluid, and breast milk samples from women with coronavirus that have been tested for COVID-19 have been negative in babies,” says Dr. Madden.
But as The New York Times notes, there’s no research suggesting how the coronavirus affects the fetus earlier in pregnancy. High fevers in the first trimester have been associated with birth defects, says the CDC. It's too early to know for sure exactly how babies will be affected, but the March JAMA study found that only three out of 33 newborns born at Wuhan Children's Hospital in China had signs of the virus, and their symptoms were mild.
Women with SARS and MERS reported pregnancy loss, stillbirth, and miscarriage in the past—so it’s possible that risks are increased for the coronavirus too. What’s more, preterm birth has been recorded for mothers positive for COVID-19—but ”it is not clear that these outcomes were related to maternal infection,” says the CDC.
How to Prevent Coronavirus Transmission
If you’re pregnant or a new mother, avoid travel to places with active coronavirus spread and don’t interact with anyone who's had potential exposure. What’s more, “basic practices encouraged for protection against any respiratory infection remain valid,” says Charles Bailey, M.D., medical director for infection prevention at St. Joseph Hospital in Orange County, California. “Stay home if you’re ill (and encourage others to do the same), cover your cough or sneeze, use disposable tissues and throw them away immediately after use, and get a flu shot if you haven't already.” The CDC also recommends the use of cloth face masks—not N95 respirators, which are critical for health care workers—in public settings where social distancing might be difficult, like at grocery stores or pharmacies.
Dr. Bailey also recommends frequently washing your hands with soap and water for at least 20 seconds. The CDC says hand sanitizer with at least 60 percent alcohol also works in a pinch. Washing your hands is especially important before eating or touching your face.
I’m Pregnant and Think I Have the Coronavirus—Now What?
If you're showing symptoms of the coronavirus (cough, fever, shortness of breath), consult your obstetrician or physician right away. Unless you live in an area with lots of coronavirus spread, “such symptoms would be much more likely to be caused by influenza or another viral infection,” says Dr. Bailey. Even so, respiratory symptoms should be taken seriously, since they may have negative consequences for the pregnancy.
If you are diagnosed with the coronavirus, your health care provider will decide on a course of treatment. “It’s also important for pregnant women with coronavirus to plan for a hospital birth due to their risk of developing complications from the virus (like pneumonia),” says Dr. Madden. She adds that newborns should also be closely monitored for the development of viral symptoms after birth.