Pregnancy and COVID-19: What do We Know?
Viral Infections and Pregnancy
Pregnancy is a time when women are naturally more careful about their health. Changes in the body during pregnancy can make women more susceptible to viral infections, especially pneumonia, which healthcare workers are usually prepared for. COVID-19 is a new virus, and there are few case studies. Much of our research or information comes from small studies conducted in the last few months or from research on other viral strains within the same coronavirus family, such as SARS and MERS. It is encouraging that pregnant women who develop a new coronavirus and their infants have positive outcomes.
The studies so Far…
The risks associated with COVID-19 in pregnancy appear to be less serious than those reported in SARS and MERS. One study published in March examined 23 relevant case studies of COVID-19 in 32 pregnant women. Of the 32 women (one set of twins, three ongoing pregnancy):
- 7 had no symptoms at all
- Two have been admitted to intensive care
- 27 had a vaginal delivery
- 2 had a cesarean section
- 15 preterm deliveries
- 0 maternal death
The most significant risk from COVID-19 appears to be preterm birth. However, it has been unclear from the studies whether this is due to the planned cesarean sections recommended as a result of the virus.
Scientists are working hard to resolve ongoing cases of pregnancy and COVID-19. Another rapid review showed that among 30 babies delivered to women who underwent testing, there were no cases of the virus passing from mother to child or “vertical transmission.” This is consistent with existing research into other coronaviruses. However, there has been a recent case study from China that found one neonate tested positive after cesarean section. In this child, a negative test of the cord and placenta indicates that the infection originated from an external source. Overall, it does not appear that babies are tested positive for the virus when mothers have been infected. Besides, the virus does not appear to pass through breastmilk as long as proper handwashing occurs.
Studies on similar viruses, such as SARS and MERS, showed a risk of miscarriage, premature delivery, intrauterine and growth restriction, as well as maternal death. The risk of miscarriage in these viruses was typically identified in the first trimester. In contrast, the risk of intrauterine and growth restriction was identified when the infection occurred after the first trimester. Maternal death was also a risk in SARS and MERS, where pregnant women appeared to be at higher risk than non-pregnant women. It is mainly because of these more severe risks from related viruses that pregnant women are currently considered to be an ‘at-risk’ group with COVID-19.
Recommendations from China suggest that more rigorous monitoring and follow-up is needed in the first and second quarters for women tested positive for COVID-19. Also, it is recommended that women who do a positive test for COVID-19 at the time of delivery quarantine from their infants for 14 days after delivery. It’s as tricky as it can be, keeping mom and baby healthy. Hospitals in Canada follow the same protocol but are making arrangements to allow mothers infected with COVID-19 to provide breast milk to their infants. It is also essential for COVID-19 mothers to attend all regular post-natal follow-up visits to ensure a return to health.
In preparation for work and delivery, expectant mothers and their birth-partners should remain cautious. An individual with COVID-19 will not be allowed to enter the birthing room – an unthinkable scenario for most couples. It is best for both partners to observe social distances and prevention practices in the weeks leading up to their due date. This means that the pregnant partner should stay at home as much as possible, and both partners should wear masks and gloves when leaving home.
Holistic support for
From a holistic perspective, the most important thing a pregnant woman can do about COVID-19 is:
- Avoid people who are sick – stay at home!
- Clean hands often with soap and water or alcohol-based hand sanitizer.
- Clean surfaces often
- Maintaining a healthy, nutritious diet.
- Support your immune system as you would typically do during pregnancy
- Supporting the immune system is always essential during pregnancy and is relatively simple:
- Taking additional vitamin D – Vitamin D Sufficiency during pregnancy has been associated with increased immune function and reduced pregnancy complications (6). Many individuals at northern latitudes are low in vitamin D. Vitamin D is widely recommended during pregnancy for these reasons.
- Consider additional vitamin C – Vitamin C is generally considered safe during pregnancy, although the benefits of general supplementation are not clear from research studies (7). Vitamin C was found to be useful as immune support for viral infections (8) but not specifically for COVID-19
- Consult a Naturopathic Doctor, Registered Herbalist, or Traditional Chinese Medicine Practitioner for information on immune herbs that are safe during pregnancy.