Effects of COVID-19 on Pregnancy

No evidence suggests that pregnant women are more likely to contract corona virus infection than the general population. However, pregnancy alters immune system of the body and response to viral infections, such as COVID-19. Hence, pregnant women have been included in the list of people at moderate risk or clinically vulnerable as a precaution.

According to WHO, pregnant women infected with corona virus are less likely thannon-pregnant women with corona virus to exhibit symptoms, but more likely to need intensive care, if severely ill. Moreover, pregnant women report at the hospital with suspected or confirmed COVID-19 are less likely to experience a fever or muscle pain. In addition, pregnant women with corona virus, who are suffering from pre-existing medical conditions, such as diabetes or high blood pressure, or those who are older or overweight, are also more likely to have severe health complications due to COVID-19.

Another study conducted on 441 pregnant women with Covid-19 from 16 countries showed prevalence of pneumonia in 96% patients. Moreover, the rate of preterm birth (before 37 weeks of gestation) in mothers infected with Covid-19 was 26%, which is nearly double than the normal premature rate of 13.6%. The investigators also reported nine maternal deaths, six still births and four neonatal deaths.

However,according to Indian Council of Medical Research (ICMR), it has been observed that cases of COVID-19 pneumonia in pregnancy are milder and are resolving well on treatment. Similarly to other respiratory syndromes such as SARS, MERS, the risk of coronavirus infection is particularly higher during the last trimester of pregnancy. Although, pregnant women infected with corona virus reported preterm birth, it is uncertain whether the preterm birth was always iatrogenic, or spontaneous.

Besides, coronavirus epidemic increases the risk of perinatal anxiety and depression, along with domestic violence in some cases. Therefore, it is crucial that support in every possible way should be provided to pregnant women and their families; specific attention should be given at their mental health.

Transmission of Covid-19 to child from pregnant mother

Observations reveal that vertical transmission (transmission from mother to baby),  is possible. However, more studies are required to ascertain the proportion of pregnancies affected and its significance to the newborn.

Currently, there are no cases of breast milk being tested positive for COVID-19.

Effects of Covid-19 on unborn baby

According to recent data, there is no evidence that Covid-19 increases the risk of miscarriage or early pregnancy loss. Moreover, no data has divulged that this virus can cause certain abnormalities in the baby. According to ICMR, getting infected with corona virus infection is currently not an indication for medical termination of pregnancy.

Advice for pregnant women during Covid-19 pandemic

  • Try to stay alert and safe, follow social distancing
  • In order to stay safe outside the home, take precautions to avoid exposure by following these measures:
  • Use appropriate face coverings such as mask
  • Wear PPE kits at work or public places
  • Wash or sanitize hands frequently
  • Limit contact with other individuals as much as possible
  • Maintain an adequate supply of your needs including medications.
  • Keep active and hydrated to reduce the risk of blood clots in pregnancy
  • Perform regular exercise and keep a healthy balanced diet
  • Take regular folic acid and vitamin D supplementation to help support a healthy pregnancy
  • Attend all of your pregnancy scans and antenatal appointments unless advised otherwise
  • Contact your maternity team, if you have concerns about the well being of yourself or your unborn baby
  • Pregnant woman may feel increased stress, fear and anxiety during this pandemic, seek professional help from your health-care provider.

Measures required for a pregnant woman with symptoms of Covid-19

  • The main symptoms of coronavirus are Sore Throat, high temperature, continuous cough or a loss or change to your normal sense of smell or taste. Majorly, people with coronavirus have at least 1 of these symptoms
  • Inform your maternity team that you have symptoms of coronavirus
  • If you feel your symptoms are worsening, this may indicate that you are developing a more severe infection that requires specialised care. So, seek medical advice as early as possible.

Testing for Covid-19 in pregnant women 

Currently, in order to minimize the spread of this covid 19, testing is available to all patients admitted to hospital, regardless of whether they have coronavirus symptoms or not.

Pregnant women who attend hospitals for urgent or emergency maternity care, including spontaneous labour and birth are offered corona virus tests.

New national guidance from the National Institute for Health and Care Excellence (NICE) recommends that individuals admitted for elective (planned) procedures should be offered testing prior to admission, following a period of self-isolation.

Procedure for testing in pregnant women 

Pregnant women are tested in the similar way as any other individual. The test involves swabs being taken from your mouth and nose.

The most effective tests take 24–48 hours for the result to be available. If you have symptoms of coronavirus and awaiting test results whilst in hospital, you may be treated as potentially infectious until the result is returned.

If you have symptoms of coronavirus but your test results are negative, your maternity team may still use caution when caring for you as in some cases, the virus doesn’t show on the test results, if you have been tested soon after you have become infected. You may be advised to take another test in a few days.

Risk of Covid-19 associated with woman and child after birth 

Currently, no report suggest that women who have recently had a baby are at increased risk of contacting coronavirus. It is assumed that immune system of a pregnant woman who recently had given birth will be normal,unless she has other forms of infection or underlying illness. However, you should remain well-nourished with a balanced diet, take mild exercise and ensure social distancing guidance is followed.

Children, including newborn, are not associated with high risk of becoming seriously unwell with the virus. Nevertheless, close observation of hygiene is necessary. Maintenance of hygiene amongst all members of the household is crucial and they should be careful while coming in contact with the baby, if they have symptoms suggestive of any illness.

Author
Nancy Jain