New Research on COVID-19 and Pregnancy

With the current global COVID-19 pandemic, pregnant women may be concerned over how the infection may affect them, their pregnancy and their baby at birth and beyond. New research from New York has looked at the impact that COVID-19 can have on pregnant women and reassuringly has shown no cases where the infection was passed from mom to baby during the pregnancy.

COVID-19 is a viral infection and can cause symptoms including cough, fever, feeling of breathlessness and loss of the sense of smell. The virus itself belongs to a family of viruses, namely the coronaviruses. Coronaviruses are responsible for infections like the common cold as well as severe diseases that have caused critical outbreaks in the past: Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

There are viral infections which are known to affect pregnant women more severely because they are pregnant. There are others that can be passed from mom to baby and affect the way the baby grows and develops in the womb, and can mean that the baby is unwell after birth. The way COVID-19 affects women and unborn babies is not fully understood. The SARS and H1N1 pandemics showed that pregnant women were more vulnerable to developing serious illness when infected and women who were pregnant were more likely to die than women of the same age and health who were not pregnant. Pregnancies affected by influenza during the pandemic in 1918 were also at increased risk of premature birth and of babies dying before delivery.

Unsurprisingly, many are concerned about how pregnant women and their unborn babies may be affected during this pandemic. There has been research already published looking at pregnancy and COVID-19. The number of women that has been studied is small. Some of these studies have shown no increased risk of premature birth or complications for the baby, whereas others have found that there is an increased risk of premature birth and that both the mothers and babies are more vulnerable to becoming unwell prior to and after delivery than those without COVID-19.

The new research looked at 43 pregnant women with COVID-19 who were cared for in two New York hospitals over a 2 week period. The women looked at in this study were nearly all in their third trimester. The results found that 86% of the women with COVID-19 had mild disease, less than 10% had severe disease and 2 women (equating to less than 5%) had critical disease meaning they needed support on the Intensive Care Unit (ICU). Nearly a third of those who tested positive had no symptoms of COVID-19. Of those who delivered during this time, more than half had uncomplicated normal vaginal deliveries. All who delivered were given an epidural (or equivalent) prior to delivery and no complications were seen as a result. All babies delivered in this time had good Apgar scores and so were not struggling with their breathing or circulation in the minutes after birth. None of the babies tested positive for COVID-19

This research is still small in terms of the number of women studied. It also does not tell us how COVID-19 may affect how a baby develops early in pregnancy. It is difficult to draw conclusions about how pregnant women may be affected when compared to women who are not pregnant. The percentage of the group studied who were severely affected was similar to that in the general population but this is not a fair comparison. Pregnant women are, on average, younger and less likely to be affected by other medical conditions than the general population. Older people with other health conditions are more at risk of developing severe illness with COVID-19 infection. However, it is reassuring that the majority of women in this group either had no symptoms or had mild disease. Also, none of the babies tested positive for COVID-19 and nearly all were well during the first few days and weeks of life at which point the study was completed.

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Letty Condon

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