This review discusses COVID-19 and pregnancy. It will highlight how the current coronavirus pandemic affects pregnant women and how pregnant women can protect themselves from the virus.
In addition, this review will answer the following questions that pregnant women may have about COVID-19:
- What is COVID-19?
- Signs and Symptoms of COVID-19?
- How do you get COVID-19 and how is it spread?
- Does COVID-19 affect pregnant women like other coronaviruses?
- Can you pass the virus to your baby while you’re pregnant?
- Is breastfeeding safe if you have COVID-19?
- Should a pregnant woman work during this coronavirus pandemic?
- Treatment of COVID-19 in pregnant women?
- If I have COVID-19, how will this affect the delivery of my baby?
COVID-19 and Pregnancy
It’s important to note that the information on COVID-19 is always changing, especially about how this virus affects pregnant women. Therefore, stay up-to-date with the latest information released by the CDC.gov.
Overview of COVID-19 (Coronavirus)
What is COVID-19?
COVID-19 is a respiratory illness caused by a new type of coronavirus that has not previously been seen in humans until now. Coronaviruses originate from infected animals that can spread the virus to humans, who then can spread it to other humans, which can lead to an outbreak.
Coronavirus outbreaks are not new. For example, certain areas of the world have experienced other coronavirus outbreaks before like SARS and MERS, but COVID-19 is the first outbreak to be a pandemic (worldwide), especially affecting the residents in the US.
The virus that causes COVID-19 is called SARS-CoV-2 (it is NOT the same virus that causes SARS but it’s genetically similar to the SARS virus). It originated from Wuhan, China in December 2019. And the first case popped up here in the U.S. in January.
Signs and Symptoms of COVID-19?
Fever, cough, shortness of breath, fatigue… however, before respiratory symptoms present themselves some patients have reported GI symptoms. The Center for Disease Control and Prevention (CDC) has stated the following:
“Some persons with COVID-19 have experienced gastrointestinal symptoms such as diarrhea and nausea prior to developing fever and lower respiratory tract signs and symptoms.” (“Coronavirus Disease 2019 (COVID-19)”, 2020)
Sign and symptoms of COVID-19 may appear up to 14 days after exposure to the virus. It’s important to note that some people can be without signs and symptoms (hence asymptomatic) and be contagious, which makes this virus difficult to contain and easier to spread.
How do you get COVID-19 and how is it spread?
The virus infects the respiratory tract, but how does it get there?
It’s primarily enters the body through respiratory droplets or by touching a contaminated object and then touching the mucous membranes (mouth, nose, or eyes).
The virus is spread in respiratory droplets when a person, who is infected with the coronavirus, sneezes, coughs, or does any activity that creates water droplets out of their mouth or nose. These activities produce water droplets that contain the virus. If a person is close enough when these activities happen, the unsuspecting person can easily inhale the virus into their respiratory tract. This is why social distancing is very important (at least 6 feet or more).
In addition, if a person touches an object with the virus and then touches their eyes, nose, or mouth, they can infect themselves with the virus.
Now with that overview, let’s take that information and apply it to pregnancy.
With pregnancy, your body changes how the immune system works. These changes can actually make the pregnant woman more susceptible to germs like viruses, which can cause the body to have a harder time fighting the germ. Unfortunately, this can lead to serious complications, and this has been seen in pregnant women who have been infected with other coronaviruses like SARS.
However, does COVID-19 affect pregnant women like other coronaviruses and respiratory illnesses?
Unfortunately, the research at this time is very limited and not conclusive on how COVID-19 affects pregnant mothers and their babies compared to other coronaviruses.
However, The American College of Obstetricians and Gynecologist, provided a little insight into how COVID-19 may affect pregnant: Here is a direct quote from them:
“pregnant women should be considered an at-risk population for COVID-19. Adverse infant outcomes (eg, preterm birth) have been reported among infants born to mothers positive for COVID-19 during pregnancy.” (“Novel Coronavirus 2019 (COVID-19)”, 2020).
Can you pass the virus to your baby while you’re pregnant?
The data is not clear on if this is possible and from what is known, it seems like there is a low chance of this happening.
Harvard Health noted some recent studies about cases of pregnant women having COVID-19 and giving birth (Farid, MD & Memon, MD, MSc, 2020). These studies reported the following results:
“38 women infected with COVID-19 had newborns who tested negative for the virus (Schwartz, D. (2020).”
“Out of 33 women infected with SARS-CoV-2, 3 of the newborns tested positive for the virus and had signs and symptoms. However, it’s not clear if the babies become infected while in utero or after birth because they were tested later on when they were days old. These were women in Wuhan, China. (Zeng et al., 2020)”
Is breastfeeding safe if you have COVID-19?
According to CDC, it’s not known if the virus can present in breast milk. The studies are very limited, but it has been found that this wasn’t the case for other types of coronaviruses like SARS.
Should you breastfeed if you have COVID-19? According to WHO, yes if you want to breastfeed you should but make sure you are following transmission precautions (“Q&A on COVID-19, pregnancy, childbirth and breastfeeding”, 2020):
- wash hands often (before and after touching baby)
- wear a mask
- following respiratory guidelines (coughing, sneezing)
- disinfecting surfaces and supplies
- if you’re too sick: pump milk (follow transmission precautions) and have someone who is well feed the baby via a bottle
Pregnant and working as a healthcare provider, should you continue?
It depends on what type of environment you are working in, procedures you have to do, and the virus activity in your local area. This is something that you want to discuss and analyze with yourself and manager.
Currently, the CDC doesn’t have specific guidelines that state pregnant women in healthcare can’t work in certain areas, but they do recommend that facilities consider limiting a pregnant healthcare provider’s contact with patients who are positive for COVID-19. So, this is definitely something you want to analyze.
Treatment of COVID-19 in pregnant women?
There is no specific treatment for people who become infected with this virus. If you think you have it don’t rush to your OB office (this is because you can expose others), but first call them and they will advise you what to do. They may refer you to a testing site or have you come in for a test. Be sure you wear a mask when you go.
Mild cases: hospitalization is rare, isolate self from others, immediately report: difficulty breathing, a decrease in fetal activity (if you’re far enough along to feel it), contraction pain, bleeding, or leaking of amniotic fluid.
Severe cases: hospitalization is needed and other treatments to help with presenting symptoms, like respiratory problems
If I have COVID-19, how will this affect the delivery of my baby?
The CDC currently recommends temporarily isolating baby from mother due to the potential of spreading the virus to the baby. Your doctor will assess the situation (every person’s situation will be different because it depends on how severe you have it, what’s available at the facility you deliver etc.). If you have this virus, be sure to discuss and develop a detailed birth plan with your OB provider.
You may be interested in: More COVID-19 Information
Coronavirus Disease (COVID-19) and Breastfeeding. (2020). Retrieved 7 April 2020, from https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/covid-19-and-breastfeeding.html
Farid MD, H., & Memon, MD, MSc, B. (2020). Pregnant and worried about the new coronavirus? – Harvard Health Blog. Retrieved 7 April 2020, from https://www.health.harvard.edu/blog/pregnant-and-worried-about-the-new-coronavirus-2020031619212
Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. (2020). Retrieved 7 April 2020, from https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
Novel Coronavirus 2019 (COVID-19). (2020). Retrieved 6 April 2020, from https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019
Q&A on COVID-19, pregnancy, childbirth and breastfeeding. (2020). Retrieved 6 April 2020, from https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding
Schwartz, D. (2020). An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Archives Of Pathology & Laboratory Medicine. doi: 10.5858/arpa.2020-0901-sa
Coronavirus Disease 2019 (COVID-19) Update—Information for Clinicians Caring for Children and Pregnant Women. (2020). Retrieved 7 April 2020, from https://emergency.cdc.gov/coca/calls/2020/callinfo_031220.asp
Zeng L, Xia S, Yuan W, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. Published online March 26, 2020. doi:10.1001/jamapediatrics.2020.0878