COVID-19: Still many questions related to pregnancy
There is still plenty not yet known about the power of the novel coronavirus — including its potential impact on a woman's pregnancy and the new life she's creating.
Preliminary data about COVID-19 and pregnancy appear more pleasant than alarming, but health professionals warn it's still too early to give solid answers to many questions related to the topic.
"We were seeing pregnant women who got very, very ill with H1N1, and it doesn't appear that COVID-19 is doing the same. I hope it stays that way," said Dr. Lance Bruck, president and chair of Jersey City Medical Center's Department of Obstetrics, Gynecology and Women’s Health.
The Centers for Disease Control and Prevention notes it does not know whether pregnant women have a greater chance of getting sick from the respiratory illness, or whether they are more likely to have serious illness as a result. But pregnant women do experience changes in their bodies that could make them more susceptible to viral respiratory infections.
Whatever the risk, pregnant women can protect themselves from getting COVID-19 the same way the general public would. The CDC advises pregnant women to avoid people who are sick, clean their hands with soap and water or an alcohol-based hand sanitizer, and cover their cough.
"Patients at home with mild symptoms need to self-quarantine for a minimum of 14 days," said Justin Brandt, an assistant professor obstetrics and gynecology at Rutgers Robert Wood Johnson Medical School. "They should not go to their routine prenatal visits until they have spoken to their doctor's office and received instructions."
Patients with more severe symptoms, Brandt said, may need to be evaluated in a hospital.
Effects on the unborn/newborn baby?
Though unclear whether the outcomes were related to maternal infection, the CDC said, there's been "a small number of reported problems" with pregnancy or delivery — preterm birth, for example — in babies born to mothers who tested positive for COVID-19 during their pregnancy.
There's not a huge sample size, but no babies born to mothers with COVID-19 have tested positive for the virus, the CDC said. And the virus was not found in amniotic fluid or breast milk.
But neonatal transmission is a certain risk. Family members and friends with COVID-19 can transmit the infection to newborns.
"The majority of cases of COVID-19 involving children, including newborns and babies, have been asymptomatic or mild," Brandt said. "We need to prevent these infections, though, because there have been reports of severe disease, even deaths, in children."
Because of this risk, the safety of breastfeeding a newborn will need to be determined on a case by case basis. A mother with a confirmed case, or is symptomatic and under investigation, should consult her family and healthcare providers when determining whether and how to breastfeed, the CDC said. The agency tells mothers to consider having a healthy individual feed the expressed milk to the infant, if possible.
"The mother can still express breastmilk, which can be fed to her newborn," said Dr. Bruck at Jersey City Medical Center, of mothers with symptoms. "You can breast feed, but it's got to be done through a bottle."