Coronavirus: how will it affect my pregnancy, my unborn child and my baby?

Expert advice from Obstetrics and Gynaecology Registrar Dr Will Dooley and family GP Dr Philippa Kaye, on what you need to know about coronavirus (COVID-19) and your pregnancy, baby and breastfeeding

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If you’re pregnant or have a baby, you need specific questions answered about coronavirus (COVID-19). So we’ve talked directly to three experts Dr Will Dooley, Obstetrics and Gynaecology Registrar, of happyparentshappybaby.com, Dr Andy Smith, Paediatric Registrar doctor, and family GP Dr Philippa Kaye and researched the latest coronavirus advice from the NHS and the Royal College of Obstetricians and Gynaecologists (RCOG). Here are the key things you need to know…

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Am I more likely to get coronavirus if I’m pregnant and will I get it more severely?

“When you are pregnant you have a higher risk of catching infections than a woman who isn’t pregnant. However, in cases of coronavirus, pregnant women do not appear more likely to develop complications than women who aren’t pregnant,” advises Dr Will Dooley.
Dr Philippa Kaye agrees, adding: “It seems that, like the rest of the healthy, young population, if there are no underlying health conditions, your symptoms are likely to be mild to moderate.”
UPDATE (May 11 2020): New research from the University of Oxford, in collaboration with the RCOG supports the view that “pregnant women are at no greater risk of severe illness than the non-pregnant population”.
But the research also finds that:
  • Over half (55%) of the small number of pregnant women who have been admitted to hospital with coronavirus symptoms were from a black or minority ethnic (BAME) background. In light of this, RCOG say they are updating their guidance “to reflect that BAME women should be told at each contact with a health professional that they may be at higher risk of complications of coronavirus, and advised to seek help early if they are concerned about their health”.
  • The majority of pregnant women who did become severely ill were in their 3rd trimester of pregnancy. This, say the researchers, “emphasises the importance of social distancing” for women in the last few months of pregnancy (see Do I need to take special precautions if I’m pregnant? below).

Do I need to take special precautions if I’m pregnant?

Yes. Purely as a precautionary measure, pregnant women have now been added to the “at-risk groups” that include the over-70s and those with underlying medical conditions. The current NHS advice (March 16 2020) for at-risk groups is to follow these guidelines to avoid catching the virus:
  • Wash your hands frequently and thoroughly
  • Avoid contact with people who have symptoms of the virus
  • Avoid pubs, restaurants, theatres and cinemas
  • Work from home, if you can
  • Only travel on public transport if you really need to
  • Don’t have visitors to your home (including friends and family)
UPDATE: The Royal College of Obstetricians and Gynaecologists has now said (Saturday March 21 2020) that pregnant women who are more than 28 weeks pregnant should be particularly attentive to “social distancing” and minimising social contact with others. 
 
On Tuesday March 17 2020 The Chief Medical Adviser said that pregnant women are advised to “minimise social contact” for 12 weeks from Saturday March 21 2020.

You should still keep your antenatal appointments during this time, however, says Gill Walton, chief executive of The Royal College of Midwives as they are “essential to ensure [your] wellbeing and [that of your] baby.” 

The government has also indicated that on Monday March 23 2020, they will be contacting those thought to be at particularly high risk of getting seriously ill with the virus, and giving them specific advice about what to do.

I don’t have symptoms of coronavirus. Is it still OK to go to my antenatal appointments and scans?

Yes, if you have a scan or appointment due soon but RCOG advise that you contact your maternity team first, as appointments may be subject to change if, for example, there are fewer staff available.

If you don’t have an appointment or a scan for a while yet, you should wait to hear from your maternity team. There may be a need to reduce the number of antenatal appointments you have. You may also be asked not to bring children to your appointments.

If you have an appointment cancelled or delayed and aren’t sure when your next one will be, you should let your maternity team know by calling the contact numbers given to you when you had your booking-in appointment.

Could coronavirus affect my unborn baby? Can it be transmitted through the placenta?

The current scientific thinking on this is reassuring. Dr Philippa explains, “There has not been any evidence that the virus can pass to the baby through the placenta while you are pregnant1 so it is unlikely to cause any issues with the baby. It also currently does not appear to be associated with an increased risk of miscarriage.”

Dr Will adds, “Placentas from 3 women who were infected with coronavirus all tested negative for the virus,” says Dr Will. “It is also reassuring that samples of amniotic fluid, cord blood, baby’s throat swabs and breastmilk, taken from women with confirmed coronavirus infection, have all tested negative.

“There are 2 reported cases where a newborn tested positive for coronavirus but it is felt that this is unlikely to have been via the placenta, but more likely to have occurred after birth.”

There is similar advice from RCOG, which states in its current guidelines, “As this is a very new virus we are just beginning to learn about it. There is no evidence that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission). It is therefore considered unlikely that if you have the virus it will cause abnormalities in your baby. There is also no evidence to suggest an increased risk of miscarriage. ”

Over the coming weeks and months it is likely pregnant women in the UK will test positive for coronavirus (COVID-19). While the data is currently limited it is reassuring that there is no evidence that the virus can pass to a baby during pregnancy.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists

Is there any evidence of a risk of premature birth if you have coronavirus ?

It’s still too early for experts to have a clear answer on this. “Some women in China who tested positive for coronavirus have had premature babies,” says Dr Philippa. “However it isn’t clear if this was due to the virus or not at present.”

The RCOG has a similar view. “Some babies born to women with symptoms of coronavirus in China have been born prematurely. It is unclear whether coronavirus caused this or the doctors made the decision for the baby to be born early because the woman was unwell. As we learn about the risk of pre-term birth and coronavirus infection, we will update this information.”

Once my baby is born, should I stay at home to reduce the risk of either of us getting coronavirus?

The current guidance does not suggest to do this currently, although we are hearing from new mums who post in our MadeForMums Chat forum that some maternity wards are not allowing visitors (other than the new mum’s partner) and that some new mums are being told not to introduce their baby to the new grandparents for 12 weeks. We will update/confirm these details once we hear anything official.

Dr Andy Smith says: “At the time of writing, public health organisations and the Government have not advised for babies to be isolated routinely. The rules for self-isolation are widely available, but a reputable source is www.gov.uk

An African American mom gently cradles her newborn daughter against her chest. She is wrapped up and swaddled and is sleeping with a content expression. Mom is tenderly gazing down at her.

Should I avoid having visitors while my baby is newborn to reduce the risk of contracting coronavirus?

“It would be sensible to avoid contact with people who are unwell or who have been exposed to the virus and to follow the general advice to minimise spread of disease,” says Dr Andy. “These include regular, effective hand-washing and safe sneezing/coughing practices.”

Is it still safe to breastfeed? Can coronavirus be transmitted through breastmilk?

“There currently isn’t evidence that you can pass on the virus through breastmilk,” says Dr Philippa.

The RCOG advises continuing breastfeeding, stating, “At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.”

If you have coronavirus yourself, you’re currently advised to discuss the risks and benefits of breastfeeding with your GP or midwife. The main risk of infecting your baby is not from your breastmilk, but from the fact that you have close contact between you and your baby and may pass the virus on through airbone droplets.

According to the RCOG, if you have coronavirus and want to breastfeed your baby, the following precautions are recommended:

  • Wash your hands before touching your baby, breast pump or bottles
  • Wear a face-mask for feeding at the breast
  • Follow recommendations for pump cleaning after each use
  • Consider asking someone who is well to feed expressed breast milk to your baby.

If you’re feeding your baby with expressed milk or formula, the advice is to make sure you carefully follow sterilisation guidelines available on the NHS website.

Is my new baby more at risk of getting coronavirus than adults?

“There is no data to suggest children are at greater risk of catching coronavirus,” explains Dr Andy. “In fact, most serious cases have occurred in the elderly and children have generally had milder disease. Young babies are more vulnerable to infections generally, but there is not yet the data to suggest they are at increased risk of serious disease caused by coronavirus.”

What symptoms will my baby have if they get coronavirus (COVID-19)?

The symptoms would be the same as in adults, explains Dr Andy.

  • Fever
  • Cough
  • Runny nose
  • Potentially difficulty in breathing
  • Diarrhoea has also been reported in children

Dr Philippa offers this important reminder: “Any newborn who develops a fever up to 28 days of age must always be seen by a medical professional – so please do contact 111 if this occurs.”

Important notice: The information in this article is correct at the time of writing (11/05/2020) but is subject to change if further research, information and guidance comes to light.  

Reference

1. Novel coronavirus infection and pregnancy, H Yang et al. Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.22006

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About our experts

Dr Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

Dr Will Dooley

Dr Will Dooley is an Obstetrics and Gynaecology Registrar Doctor. He consulted with Dr Andy Smith, a Paediatric Registrar doctor, on this article.  They both teach on the Happy Parents. Happy Baby antenatal course, which combines expert teaching from a whole team of specialists, including a midwife, obstetric doctor, hypnobirthing instructor, paediatric doctor, feeding consultant and first aid instructor. The team also creates a social experience designed to help you connect and make friends with other parents to be. Their courses run across London and Essex.

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