Coronavirus and Pregnancy
Pregnancy is an exciting time of life but can be very scary when we are faced with a pandemic like the novel coronavirus (COVID-19).
There are lots of questions to be answered and lots of concerns to be addressed. First, since this virus is so new, there is a lot we are still learning.
However, there is some information from small research studies and observations that can guide us and try to address concerns at this point.
Protection During Pregnancy
According to the Centers for Disease Control and Prevention (CDC), pregnant women are at an increased risk for severe illness from COVID-19. Additionally, COVID-19 in pregnancy might put you at an increased risk for other adverse outcomes, such as preterm birth.
The best way to fight off infection is to protect oneself from illness in the first place. The best ways to protect against coronavirus are wearing a mask, social distancing, avoiding people who are sick and proper hand-washing with soap and water or an alcohol-based hand sanitizer.
If a pregnant woman thinks she may have COVID-19, she should notify her healthcare provider and/or call the Health Department and follow their advice.
COVID Vaccine and Pregnancy
While the Federal Drug Administration's emergency-use approval of the current COVID-19 vaccine is is for people age 16 and up, currently, there are no data on the safety of COVID-19 vaccines in women who are pregnant or breastfeeding. Vaccine trials were not performed on pregnant women and so there is no information as to the effects of the vaccine on the unborn baby.
Similarly, there are no safety data available on the effects of mRNA vaccines, which is the type of vaccine used for COVID, on the breastfed infant or milk production. But because of the way the mRNA vaccines work there is not a live virus in them, and they are not thought to be a risk to the breastfed infant.
All pregnant women, women who plan to become pregnant, and women who are breastfeeding should consult with their physician before being vaccinated.
Practicing social distancing may be more difficult due to prenatal visits that are monthly or weekly. If the pregnant woman is sick, she should either reschedule her prenatal appointment or wear a mask.
A good alternative is virtual appointments, if available through the provider. Telemedicine is becoming more common, and the University of Maryland Medical System (UMMS) offers many options for telemedicine appointments.
Telemedicine is ideal for virtual prenatal visits, at-home monitoring (weight, blood pressure, fetal heart rate, blood sugar, etc.), consultation with specialists (maternal-fetal providers, genetic counselors), online communication with providers, mental health care, virtual postpartum visits and lactation support.
At this time, the University of Maryland Medical System encourages all patients to utilize the MyPortfolio service to communicate with their providers online, giving patients better access to providers rather than needing to schedule appointments to have questions answered.
Risk of Preterm Birth
According to a study published in September 2020 of approximately 600 pregnant women, the prevalence of a preterm delivery (at less than 37 weeks) during COVID-19–related hospitalizations was 12.6 percent. That was higher than in the general U.S. population in 2018, which was 10 percent.
In the study, symptomatic women delivered early three times more often than COVID-positive women without symptoms.
Risk of Pregnancy Loss
To date, there has not been any evidence that links the novel coronavirus to increased risk of pregnancy loss. The statistics currently show pregnancy loss to be equal in women with COVID-19 and the general population. Additionally, there is no current evidence that COVID-19 causes fetal malformations.
Passing the Virus to the Baby
According to various studies, the risk of passing the virus to the baby in the womb appears to be very low. There have been a few cases of newborn infections, but it was not clear whether the baby was infected before or after birth.
The Virus and Breastmilk
Current evidence suggests that the virus does not spread to a baby through breastmilk, and the CDC encourages mothers to breastfeed their babies to introduce antibodies and other protection against illness.
If a mother with COVID-19 chooses to breastfeed her baby, she should practice proper precautions to not spread the virus to her baby. These include washing her hands before touching the infant and wearing a mask if possible while the baby is at the breast.
Another precaution would be to have a well person feed the baby with expressed milk. In this case, the mother should take proper precautions while pumping, such as washing her hands before touching any part of the pump or bottle parts and following the recommendations for cleaning the pump after each use.
Most births take place in hospitals. Most hospitals, such as all of the University of Maryland Medical System (UMMS) facilities, are taking special precautions to keep patients safe.
To protect the patients, temporary visitor restrictions have been put in place. We highly recommend that women check the visitation policy of the hospital at which they plan to give birth. The woman's birth plan may have to be altered to accommodate a tighter policy.
Additionally, most hospitals use negative pressure rooms for contagious patients, which will keep other patients safer. Hospital staff have been trained to take proper precautions while treating patients as well.
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