Studies are underway to find out as much as possible about pregnancy and the coronavirus. Experts are basing current recommendations on findings from a few case reports on the novel (new) coronavirus behind the current pandemic, along with research on other forms of coronavirus responsible for earlier outbreaks of severe acute respiratory syndrome (SARS) and Middle East respiratory virus (MERS). Read on to find out the latest answers and expert advice regarding pregnancy and COVID-19. RELATED: Experts Tips on the Coronavirus Crisis: Be Prepared, Don’t Panic
Are Pregnant Women More Likely to Get Infected With Coronavirus?
So far there hasn’t been much data about whether pregnant women are at higher risk of contracting the coronavirus, according to Jeanne S. Sheffield, MD, director of the division of maternal-fetal medicine and researcher in infectious diseases in pregnancy at Johns Hopkins Medicine in Baltimore. But “from the limited information on COVID-19 that we have, with most of that data being out of China, it does not appear that pregnant women are more susceptible than the general population,” says Dr. Sheffield.
Are Pregnant Women at Risk of Developing a More Severe Case of COVID-19?
There isn’t much data yet on whether pregnant women are at higher risk of developing a more severe case of COVID-19, according to Athena Kourtis, MD, PhD, a member of the American Academy of Pediatrics’ Committee on Infectious Diseases and clinical professor of pediatrics at Emory University School of Medicine in Atlanta. An analysis by the World Health Organization (WHO) of 147 pregnant women included 64 who were confirmed to have COVID-19, 82 who were suspected of having the virus, and 1 who had no symptoms. The researchers found that of that group, 8 percent had a severe case and 1 percent were critically ill. Typically, pregnancy induces many physiologic and immunologic changes that put pregnant women at higher risk for more serious complications from many infectious diseases, noted Dr. Kourtis in an email to Everyday Health. “For example, pregnant women are at higher risk of contracting more severe influenza and are more likely to require hospitalization due to influenza,” she noted. This increased risk can be due to several factors, according to Kourtis. “Pregnancy may make the immune system less able to fight these viruses effectively, and it can also decrease the capacity of the lungs,” she noted. “Complications that can lead to hospitalization can include significant pulmonary issues,” Sheffield adds, explaining that patients sometimes develop pneumonia and might, in extreme cases, require intubation (a breathing tube). The Centers for Disease Control and Prevention (CDC) recommends that women get vaccinated for the flu at any time during their pregnancy. A study published in May 2019 found that a flu shot reduced a pregnant woman’s risk of being hospitalized due to the flu by an average of 40 percent. RELATED: 4 Misconceptions About the Coronavirus
Are There Risks for Birth Abnormalities With COVID-19, as With the Zika Virus?
The Zika virus was known to cause abnormalities in the fetus, particularly those related to the brain, prompting a heightened research focus, according to Sheffield. But “based on the information we currently have, the coronavirus hasn’t been associated with an increased risk of abnormalities,” she says.
Are the Risks Posed by COVID-19 Greater or Less for Women Early in Their Pregnancy as Opposed to Later in Their Pregnancy?
We don’t know enough yet to say, according to Sheffield. “With other respiratory viruses, the risk for complications grows the further along the patient is in pregnancy,” she says. “In the original SARS epidemic and MERS, both coronavirus infections, pregnant women who were infected were more likely to have complications, particularly if they were in the third trimester. We haven’t seen that yet with COVID-19, but again, we’re basing this on very little data.” RELATED: Can You Get Coronavirus From Your Dog? Plus More Pet-Related Questions Answered
If the Mother Has COVID-19, Can the Baby Get It In the Womb? What About After Birth?
There’s isn’t good data to answer this question yet, says Kourtis. “There have been some cases of pregnant women with COVID-19 near the end of their pregnancy whose babies were not infected with the new coronavirus. There have also been a few cases of pregnant women with COVID-19 who delivered prematurely,” she noted, referencing a study published in March 2020 in The Lancet. “There are some very young babies that are infected with COVID-19,” says Sheffield. “We think they probably were infected right after delivery.”
Is Breastfeeding Safe if the Mother Has COVID-19?
So far, the virus has not been detected in breast milk itself, says Sheffield. “We don’t think there’s a high risk of the virus being transmitted through the breast milk. However, the virus is transmitted by respiratory droplets" — produced when an infected person coughs or sneezes — “so there’s a good chance that the mom could infect the baby while breastfeeding, not through the breast milk but through droplet exposure,” she says. We know that breast milk is the best source of nutrition for most infants; the decision about whether and how to start or continue breastfeeding is one the mother needs to make in coordination with her family and healthcare providers, according to Kourtis. “A mother with confirmed or suspected COVID-19 should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast,” noted Kourtis. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use, she adds.
What Precautions Should Pregnant Women Take to Avoid Being Infected With the Coronavirus?
Pregnant women need to follow the general guidance issued by the Centers for Disease Control and Prevention (CDC), according to Kourtis, including limiting potential exposure by avoiding large gatherings, nonessential travel, and people who are sick, and practicing good hand hygiene. It’s appropriate to follow the guidelines for the general population, agrees Sheffield. “But if you are pregnant and you have traveled to one of these high-risk areas or if you are running a fever with respiratory complaints, such as cough, congestion, or sore throat, please call your doctor so they can see you right away. Don’t try to ride it out at home,” she says. RELATED: Handling Travel Concerns as Coronavirus Anxieties Continue