July 15, 2020

Coronavirus & Pregnancy – What We Know So Far

By Katie Hilton

Katie Hilton is a dual qualified nurse, midwife and health visitor and the expert adviser for MAM UK. She is also a mu’ma herself to one cheeky little man.

UPDATE – 16/03/2020

The UK government provided an update today for women who are currently pregnant. Whilst there is no additional evidence of any potential risk to pregnant women and unborn babies they have advised additional precautionary measures women should take. In addition, The Royal College of Obstetricians and Gynaecologists have also issued a response statement. Please find links to both below.

UK Government – Guidance on Social Distancing

Royal College of Midwives – Response to government advice

What We Know So Far

We understand many women currently pregnant may be feeling a little anxious in relation to the current coronavirus outbreak. COVID-19 is a new type of a coronavirus which originated in Wuhan, China towards the end of 2019. To date China is still the country with the highest number of cases, with Italy being the most affected country in Europe. The situation across the world is changing daily and for the most current advice, you should always consult Public Health England, visit the NHS and Department of Health websites and speak with your own Midwife or Obstetrician.

Please note that all information up to date from 12/03/2020. All information in this post is from The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Royal College of Paediatrics

The Risks To Pregnant Women

Because COVID-19 is a new virus there is very little data and research related to the potential complications for both expectant mothers and unborn babies and long-term effects. At present pregnant women do not appear to be any more susceptible to the effects of the outbreak.[1]

Extra attention does, of course, need to be paid to pregnant women who also have comorbidities such as gestational diabetes and raised blood pressure; and those with pre-existing conditions, particularly until we have more evidence and research. We do know that pregnant women are slightly immunocompromised compared to the general population, therefore it is particularly important to take note of handwashing practices and pay particular attention to whether trips are essential and attempt to steer clear of anybody displaying cold and flu symptoms.

How is it Transmitted?

Transmission of the virus appears to be predominantly through human to human contact, mainly through respiratory and faecal routes, it can also be transmitted through objects such as door handles, so far only one case of coronavirus being transmitted from mother to baby during pregnancy has been reported globally, opinion from leading expert suggests that the risk of transmission during pregnancy is low, the risk to a neonate when breastfeeding is also thought to be low and as yet there are no known transmissions through this route.

Travel advice related to pregnant women will as ever be directly from the Foreign and Commonwealth Office, but as ever always ensure you have adequate travel insurance and check that your policy covers pregnancy and offers cover for birth and the care of a newborn baby whilst overseas. Recommendations are currently to minimise foreign travel unless absolutely necessary. [2]

What to do if you are infected

If you do become infected with COVID-19 during pregnancy most women will experience mild or moderate cold/flu-like symptoms including a cough, fever and shortness of breath. The more severe symptoms such as pneumonia are most likely to occur in people aged 60+ and those with long-term health conditions. The more severe symptoms could occur in pregnant women but so far have been rare, to date there is only one such case reported globally, of which this woman has now fully recovered. [3]

If you do experience breathing difficulties it’s important to seek help early. There are some reported cases of preterm birth in women with COVID-19 but at the moment it is unclear whether this was directly linked to the virus or to some other complications in their pregnancy.

To date, there is limited evidence or data which suggests an increased risk of such things as miscarriage/ birth defects in relation to COVID-19.

Globally we are still in the early stages of the virus, there is no evidence/information to the effect of COVID-19 if contracted earlier in pregnancy (1st and 2nd trimester).

If you think you have been exposed to COVID-19 or you are experiencing symptoms suggestive of the virus and you’re in England you should call NHS 111 or use the online tool. If the situation is an emergency as ever phone 999 and inform them of possible COVID-19 exposure. If necessary, swabs will be arranged to test for exposure. If you do have symptoms you will be advised to self-isolate which includes the following:

  • Stay indoors and avoid contact with others for 14 days
  • Do not go to school, work, NHS settings or public areas
  • Do not use public transport
  • Stay at home and do not allow visitors
  • Ventilate the rooms by opening a window
  • Separate from other members of the household as far as possible
  • Use your own towels, crockery and utensils and eat at different times
  • Ask friends, family or delivery services to run errands, but ask them to leave items outside [4]

If you have potentially been exposed to COVID-19 contact your maternity care provider such as your own Midwife or antenatal clinic to discuss your antenatal care and appointments. If you have an issue related to your pregnancy do not attend maternity units or A&E unless in urgent need of care, called the maternity assessment unit before attending.

Please note that all information up to date from 12/03/2020. All information in this post is from The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Royal College of Paediatrics