This post will attempt to answer the following questions:
- What is the risk for pregnant women of contracting the coronavirus?
- What is the risk of it being transmitted to the baby?
- Should a pregnant mother avoid going to the hospital?
By far the most positive news with the COVID-19 pandemic is that is has spared children. I often shudder at the thought of what would be if the virus had been doing to children what it is doing to the elderly populations. With that in mind I have been getting many questions about COVID-19 and its impact on pregnant women and their newborns. Pregnancy is its own concoction of physical discomfort and sleep deprivation mixed up with hormone imbalances to create a unique state of anxiety. And that’s when there’s not a horrifying plague circulating around the world.
Additionally this population presents a unique challenge during this or any pandemic because most pregnant women go to their obstetricians frequently and are admitted to the hospital for delivery. These contacts with the healthcare system would seemingly increase their risk for contracting the virus. It has also created gut wrenching stories of young mothers delivering their babies alone trying to breathe somehow through a surgical mask. So what is the risk for mother and baby? Fortunately the news is good (for once).
Limited available data suggest that pregnancy and childbirth do not increase the risk for acquiring a coronavirus infection, do not worsen the clinical course of COVID-19 compared with nonpregnant women of the same age, and most infected mothers recover without problems.
As an example, in one study of 43 pregnant women with confirmed COVID-19 and another study at Columbia University the percentages of mild, moderate and severe disease were similar to those described for non-pregnant adults with COVID-19 infections. Those who do develop severe disease have an increased risk of complications which is likely related to severe maternal illness and not direct effects of the virus itself but severe disease is not common.
COVID-19 is not worse in pregnant women than nopregnant women
So it appears that COVID-19 is not worse in pregnant women than nopregnant women. The news is even better for the babies. SARS-CoV-2 has not been detected in cord blood, amniotic fluid, or the placenta One report also found no evidence in breast milk. Further, in the above studies there have been no confirmed cases of COVID-19 detected in neonates upon initial testing on the first day of life.
There can be transmission from Mother to baby after delivery through the respiratory route but this is rare. Less than 2% of cases of COVID-19 have been in people under 18 years old. And only 15% of the 2% have been in children under 1 year old. As the children get younger, infection gets less prevalent.
This is all very good news. I have heard pregnant women express concerns about delivering in the hospital and I worry that they will delay going to the hospital and end up delivering in an unsafe environment. All of the evidence points to the fact that it is safe for mother and baby to be in the hospital. It is a good idea to take appropriate precautions. This would include wearing a mask and sanitizing your hands while holding or feeding the baby. If mom has been infected and recovered she will pass those antibodies to the baby through the breastmilk. This, plus the fact that the virus has not been found in breastmilk, argue that breastfeeding should not be withheld because of a concern for spreading the virus, it should be encouraged. If mom gets infected, it is probably a good idea to stay away from baby as much as possible and have someone else feed the baby pumped breastmilk.
As with everything else, information is changing daily, but these recommendations have been pretty consistent. The most important thing of all is that you don’t name the baby corona, COVID, or SARS. That would lead to lifelong scarring.