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Pregnancy and COVID-19

COVID-19, the disease caused by the coronavirus, can be more dangerous for pregnant people and their babies.


This article is pending medical review.

Contributors

Written by Alessandra Papitto

Reviewed by Carolin Becker, Mariam Hamadeh and Juliëtte Gossens

Edited by Juliëtte Gossens

 

COVID-19 is an infectious disease caused by the coronavirus, a tricky guest that can lead to symptoms like coughing, fever, and difficulty in breathing.


In the wake of the COVID-19 pandemic, one of the most urgent issues has been how the virus might affect the most vulnerable people. Among these, expectant parents have faced unique challenges. Pregnancy is a special experience but can bring several concerns as well, particularly in light of COVID-19. This is still true today, even though the worst of the pandemic is over in most places.


This article explores the complex relationship between pregnancy and COVID-19, shedding light on the latest findings, recommendations, and guidelines.



What we're covering




 

Infection with Coronavirus

Viruses that lead to pneumonia and breathing problems have always been concerning for pregnant parents. Even though we've made progress in fighting COVID-19 with vaccines, the virus is still a present threat. So, it's important to understand how COVID-19 affects pregnant parents (1).


Although pregnant parents are not more likely to be infected with the coronavirus compared to other healthy adults, the infection does pose a higher risk of poor outcomes during pregnancy, especially if the expecting parent is not vaccinated (read more about this below) (1,2).


While extremely rare, it is possible for the virus to be passed from you to your unborn child during pregnancy or childbirth. Most infants, however, will not have COVID-19 illness, and those that do often make a full recovery (3).


Risks for You and Your Baby

The risk of severe COVID-19 disease during pregnancy is higher. But the risk factors for getting severe COVID-19 during pregnancy are similar to those of others (4). Among these risk factors are obesity, diabetes, being older, and diseases of the heart or blood vessels (4).


COVID-19 can affect the pregnant parent and the baby in different ways:


1.     Severe Disease May Lead To Early Delivery

In case the birthing parent gets very sick and needs intensive care, doctors may need to deliver the baby early. The reasons are not fully understood, but severe COVID-19 has been associated with a 60% increase in preterm birth. This can result in a higher chance of stillbirth or miscarriage (5).


2.     Infection of the Placenta

In certain cases, the virus can infect the placenta (the baby’s life support system in the womb). This may increase the risk of the baby being stillborn or may cause problems in the placenta, leading to conditions like pre-eclampsia (see our article here). This can be harmful for both the pregnant parent and the baby (1).   


3.     The Virus May Reach the Baby

In extremely rare cases the virus can be transferred from the pregnant parent to the baby while still in the womb. This is not common and usually not harmful for the baby, but it is still something doctors need to watch out for (1).


Breastfeeding While Infected

Within the scientific community, a particular concern is whether someone who has contracted COVID-19 can breastfeed or not.


According to WHO recommendations “mothers with suspected or confirmed COVID-19 should be encouraged to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission” (6).


So, according to the latest guidelines, the risk of the baby getting infected from breastfeeding is outweighed by the problems that can arise with no breastfeeding. That means using baby formula and avoiding skin-to-skin contact, both of which have been shown to have a negative impact on the baby’s immunity (4,6).


That said, if you don’t want to (or can’t) breastfeed, especially if you’re sick, that’s OK too! The most important thing is that your baby is fed and that it’s in a safe environment.


How Do I Protect Myself and My Baby?

To prevent contracting COVID-19, you should follow the same safety measures as everyone else (3).

These measures include:


  • Getting vaccinated (see below)

  • Avoiding crowded spaces

  • Wearing a mask

  • Washing hands

  • Keeping the room well ventilated

 

Depending on where you are, some of these measures might still be in effect today. If they are, it’s an extra barrier between the virus and you. But in many – if not most – places, these measures were lifted a while ago, as the pandemic died down somewhat. In that case, try to keep your distance from people if they’re sick, keep washing your hands, and get vaccinated if you can.


Finally, if you have a fever that won’t go down or have difficulty breathing, you should seek medical attention as soon as possible.


COVID-19 Vaccines in Pregnancy

Lots of myths have been making their rounds about the coronavirus vaccine. But getting that vaccine is the best way to lower the risk of getting very sick. We know that the vaccine is safe. Many important health organizations, such as the WHO, recommend getting vaccinated if pregnant, postpartum, or breastfeeding (7).


Which vaccines to get when pregnant?



 

Pregnancy is a special journey, and COVID-19 can make it scarier. By following safety measures, and talking to your doctor about the vaccine, you can take precautions to keep your child and yourself safe.


 

References


  1. Male V. SARS-CoV-2 infection and COVID-19 vaccination in pregnancy. Nature Reviews Immunoly.2022; 22(5):277–282. DOI: 10.1038/s41577-022-00703-6

  2. Simbar M, Nazarpour S, Sheidaei A. (2023) Evaluation of pregnancy outcomes in mothers with COVID-19 infection: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology. 2023;43(1):2162867. DOI: 10.1080/01443615.2022.2162867

  3. World Health Organization (WHO). Coronavirus disease (COVID-19): Pregnancy, childbirth and the postnatal period. 2022. https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-pregnancy-and-childbirth

  4. Wastnedge EAN, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, Critchley HOD. Pregnancy and COVID-19. Physiological Reviews. 2021;101(1):303-318. DOI: 10.1152/physrev.00024.2020.

  5. Kazemi SN, Hajikhani B, Didar H, Hosseini SS, Haddadi S, Khalili F, Mirsaeidi M, Nasiri MJ. COVID-19 and cause of pregnancy loss during the pandemic: A systematic review. PLoS One. 2021;16(8):e0255994. DOI: 10.1371/journal.pone.0255994

  6. World Health Organization (WHO). Breastfeeding and COVID-19. 2020. https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19

  7. Badell ML, Dude CM, Rasmussen SA, Jamieson DJ. Covid-19 vaccination in pregnancy. BMJ. 2022;378:e069741. DOI: 10.1136/bmj-2021-069741


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.

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