Because COVID-19 is a new disease, with a history of only a few months of scientific information collected, there is not a lot of evidence that draw the links between COVID-19 infection and pregnancy, the birth process, and breast feeding.
The papers published in medical journals from studies conducted in China suggest that there is no evidence that pregnant women are more at risk of serious complications from COVID-19 than any other person. The anecdotal evidence from hospitals around the world is that there are no more cases of serious COVID-19 infection amongst pregnant women than amongst other people.
However, it is recognised that pregnancy puts stress on the immune system, and hormonal changes can affect how pregnant women are able to fight off ordinary infections. Because of changes in fluid levels in the lungs, pregnancy can cause some respiratory problems. Pregnant women are generally more susceptible to viral respiratory infections such as the flu.
COVID-19, as a respiratory infection, may be more difficult for some pregnant women to overcome, especially if they have other health complications, such as hypertension, asthma, diabetes or untreated HIV or TB.
A serious illness for a pregnant woman may have a negative impact on the foetus. Severe COVID-19 disease is associated with high fevers and low oxygen saturation. If a pregnant woman experiences poor oxygenation, the foetus may be deprived of oxygen which can pose a higher risk for lasting developmental issues. A fever and elevated body temperature in the first trimester can lead to abnormal foetal development. A fever with high body temperature in the third trimester can lead to dehydration which can trigger a premature delivery. These complications should be explained by a healthcare worker to COVID-19 positive pregnant women.
Because the virus is carried in droplets from the lungs and respiratory tract, and not in the blood, it is believed that vertical transmission, from mother to child, is not likely to happen in the womb or during labour.
To date, studies show that no infants born to mothers with COVID-19 have tested positive for the COVID-19 virus. There are also no reported cases where the virus has been found in samples of amniotic fluid or breastmilk.
Close contact between an infected mother and her baby, after delivery, might result in the infection being passed to the baby. While breastfeeding is encouraged, precautions should be taken to avoid passing on the infection, such as the mother wearing a mask or other protective clothing during breastfeeding and other close contact.
SOURCES:
WHO (including clinical guidelines for care of pregnant women and infants during COVID-19); NICD (South Africa); National Department of Health; Healthline; US National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.
UPDATED: 1 APRIL 2020
WHAT TO EXPECT IF YOU ARE PREGNANT AND HAVE SYMPTOMS OF COVID-19
If you are pregnant and have any symptoms of COVID-19, such as a cough, fever or difficulty breathing, you should call the COVID-19 Hotline on 0800 029 999 or go to your nearest clinic.
Before entering the clinic or standing close to other people, tell the person in the reception area that you are pregnant and you have symptoms for COVID-19. They might ask you to wait in a separate area, away from other people, or to wear a mask.
The healthcare worker will ask you some questions and check your symptoms. If they think you have COVID-19, they will take a sample from you to test for the virus. The sample might be a swab from your nose, or they may ask you to cough into a tube.
It can take a few days before the test results come back. During this waiting period, the healthcare worker may ask you to stay at home, and to avoid contact with your family or others in the household. They will keep in contact with you by phone.
If you test positive for COVID-19, and your symptoms are mild, then you will be asked to stay in isolation at home for 14 days, and to share the contact details of any people you have come into contact with in the past weeks, so they can also be monitored and tested. After this period of isolation, you will continue with your ante-natal visits to the clinic as usual.
If your symptoms are more serious, then you may be moved to a specialised COVID-19 facility where they can care for you until your symptoms have passed or until your baby is born. You will not be able to have visitors in this facility.
If you have symptoms of the virus when you go into labour, then you will give birth in a separate delivery room, to avoid passing the infection to other mothers. You will stay in hospital for three days after delivery, so you can be closely monitored, before you and your baby go home.
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