Corona virus and Pregnancy

Novel coronavirus (SARS-CoV-2) is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China towards the end of 2019. Most global cases of COVID-19 have evidence of human-to-human transmission. Transmission of the virus is known to occur through close contact with an infected person (within 2 metres). With regard to vertical transmission (transmission from woman to her baby antenatally or intrapartum), emerging evidence now suggests that vertical transmission is possible. However expert opinion is that it is unlikely for the baby to have any defects in development as a result.

Pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally cause more severe symptoms, particularly in the third trimester. This may be the same for COVID-19 but there is currently no evidence that pregnant women are more likely to be severely unwell needing admission to intensive care or die from the illness than non-pregnant adults. Despite this, pregnant women are advised to reduce social contact with social distancing. Most pregnant women will experience only mild or moderate cold/flu-like symptoms. Cough, fever, shortness of breath, headache, anosmia and loss of taste are other relevant symptoms. More severe symptoms like pneumonia and marked hypoxia may present in some pregnant women and early identification and assessment for prompt supportive treatment is the key. Risk factors that appear to be associated with hospital admission with COVID-19 illness include:

  • Maternal age >35 years
  • Overweight or obesity
  • Pre-existing comorbidity

Does becoming ill with COVID-19 increase risk of miscarriage or other complications?

There are currently no data suggesting an increased risk of miscarriage in relation to COVID-19. Case reports from early pregnancy studies with SARS-CoV and MERS-CoV have not demonstrated a significant relationship between infection and increased risk of miscarriage or second trimester loss. Based on data from other coronaviruses, such as SARS and MERS, the American College of Obstetricians and Gynecologists notes that pregnant women who get COVID-19 may have a higher risk for some complications, such as preterm birth. However, this data is extremely limited, and the infection may not be the direct cause of preterm birth.

So, here are some tips for pregnant women to stay safe during this pandemic :

  • Frequent hand washing with soap and water. If not available, use an alcohol based sanitizer. Keep these items on hand and use them when venturing out: a cloth face covering, tissues, and a hand sanitizer with at least 60% alcohol, if possible.
  • Social distancing is the norm. Always maintain a distance of at least 2 meters or 6 feet from others when you are in a public place. If possible, avoid others who are not wearing cloth face coverings or ask others around you to wear cloth face coverings.
  • Do not skip your prenatal care appointments or postpartum appointments. Ask your healthcare provider how they are taking steps to separate healthy patients from those who may be sick. Some healthcare providers might choose to cancel or postpone some visits. Others may switch certain appointments to telemedicine visits, which are appointments over the phone or video.
  • Do not ignore any respiratory symptoms. If you develop a cough or any respiratory distress, do not hesitate to call your doctor.
  • Stay safe. Symptoms such as high fever with or without continuous cough may indicate a possible coronavirus infection. Avoid coming in close contact with anyone showing these symptoms.
  • Although there is no vaccine available to protect against the virus that causes COVID-19, routine vaccines are an important part of protecting your health. Receiving some vaccines during pregnancy, such as the influenza (flu) and Tdap vaccines, can help protect you and your baby. If you are pregnant, you should continue to receive your recommended vaccines. Work from home whenever possible.
  • Make sure that you have at least a 30-day supply of your medicines.

Pandemics can be stressful for everyone. Fear and anxiety about a disease can be overwhelming and cause strong emotions in both adults and children. Coping successfully with stress will make you, the people you care about, and your community stronger.

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