Coronavirus and pregnancy: The facts

The coronavirus has been declared a global public health emergency by the World Health Organisation (WHO).

Much remains unknown about the virus when it comes to transmission between pregnant women and their unborn babies. According to the WHO, leading health experts from around the world have been meeting at the organisation’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease.

It is vital to identify gaps in research and fund needed priority research to help stop this outbreak, including the limited knowledge around the impact of coronavirus infection on pregnant women.

According to a research paper by H.Yang, C.Wang and L.C. Poon in the Journal for Ultrasound in Obstetrics & Gynecology, pregnancy is a physiological state that predisposes women to viral infection. Over and above the impact of Covid‐19 infection on a pregnant woman, there are concerns relating to the potential effect on the babies; therefore, pregnant women constitute a group that requires special attention in relation to prevention, diagnosis and management.

These are the facts we currently know:

• Interestingly, the impact of Covid-19 infection on pregnant women appears to be less severe.
• In a study of nine pregnant women with Covid-19 in the third trimester, no fetal death, neonatal death or neonatal asphyxia was observed.
• Although four babies were born prematurely, none of these deliveries was related directly to Covid-19 infection.
• Amniotic fluid, cord blood and neonatal throat-swab samples collected from six patients tested negative for Covid-19, suggesting there was no evidence of intrauterine infection caused by vertical transmission in women who developed Covid-19 pneumonia in late pregnancy.
• Therefore, preliminary research suggests that the virus cannot be transmitted from an infected pregnant woman to the foetus.
• Furthermore, it appears that there is no risk of vertical transmission via breastfeeding.
• The same study confirmed that the virus was not detected in the colostrum of Covid-19-infected patients.
• However, as the virus is transmitted via close contact, currently in China, all newborns are separated from their infected mothers for at least 14 days, which makes direct breastfeeding unfeasible. The mothers are, however, advised to express their breastmilk in order to maintain milk production. Once they test negative for Covid-19, they are then able to breastfeed their infant.
• Currently, there is no evidence that pregnant women are more susceptible to Covid-19 infection and that those with Covid-19 infection are more prone to developing severe pneumonia.
• There is also no evidence of vertical mother-to-baby transmission of Covid-19 infection when the maternal infection manifests in the third trimester.
•  These findings are based on a small number of cases collected over a short period of time. The cases also only included women who were late in their pregnancies and gave birth by Caesarean section.
• That means that it’s still unclear how infection with the coronavirus during the first or second trimester of pregnancy affects mothers and their babies, or whether the virus can be passed from mother to child during vaginal birth.

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