COVID-19 is a contagious condition caused by SARS-CoV-2. Its first case was reported in Wuhan, China in 2019. Since then, it has spread worldwide resulting in a pandemic. There have been many concerns about the effects of coronavirus on pregnancy. In pregnant women with COVID-19, severe effects of COVID-19 may be seen. Due to severe illness, special care, ventilator support or other equipment for breathing, and hospitalization may be required. The severe effect of COVID-19 is seen in pregnant women with certain underlying factors such as a condition, for example, diabetes, and gestational diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and age.
COVID-19 and antenatal period
Data isn’t available on how COVID-19 affects pregnancy in the first trimester. Therefore, no comments can be made about it. However, it has been reported that transmission of SARS-CoV-2 from mother to the unborn child is rare.
Stress and anxiety can result from issues such as domestic violence for which women aren’t able to seek face-to-face support due to the pandemic. This may have an adverse effect on pregnancy. The anxiety and stress cause inflammatory pathways to turn on which is associated to neuropsychiatric conditions in the offspring. Also, due to COVID-19, the changes that occur in the body during the pregnancy may last even after pregnancy. This is a concerning matter.
The lockdowns and limitation of activities due to pandemic may have an effect on doctor visits. Taking a virtual appointment is a good solution. However, in high-risk pregnancies, seeing a doctor in person is more effective than taking a virtual appointment. Therefore, one should enquire their doctor in advance about the effect pandemic will have on their care. This ensures that the patient is well informed, prepared in advance and strategizes accordingly.
COVID-19, neonatal and perinatal period
The effect of mother’s positive status on neonate’s status isn’t clear. Studies present contrary results. In three scientific studies, mothers as well as neonates were positive but the neonates had mild symptoms or were asymptomatic. In other studies, mothers were positive but the neonates weren’t.
According to World Health Organization (WHO), the benefits of breastfeeding are much more than the risk of transmission of SARS-CoV-2 from mother to the child. This is because SARS-CoV-2 infection in neonates is mild and asymptomatic. A mother can breastfeed her baby by following appropriate precautions which are to wear double mask and wash hands with a disinfectant soap and water for 20 minutes before touching the baby.
Breastfeeding and being in the same room as mother are safe for the new born when appropriate precautions are taken. In one study, when breast milk was tested four times for the presence of SARS-CoV2, it tested positive for it. The genetic evidence of SARS-CoV-2 in milk is present but it is not clear whether the virus is alive when in breastmilk. In a study of 120 neonates of which 64 were breastfed and whose mothers were with COVID, 79 were tested after 5-7 days of birth, 72 after 14 days of birth and none of them were tested positive. The study showed that when appropriate protective strategies are followed, the perinatal transmission of COVID from mother to neonate is unlikely.
By keeping themselves aware of the knowledge, which is available now, pregnant women can prevent transmission of SARS-CoV-2 to their new born. The mother should sanitize as per the directions given by doctor or caregiver. She should not sneeze while she is holding the baby. She should use a mask when she is around the baby. She should sterilize the breast pump as advised. She should clean her breast before feeding the baby.
Risks during pregnancy
Due to COVID-19, the following risks may occur during pregnancy:
Effects of COVID-19 on fetal health
COVID-19 may have the following effects on fetal health:
Outcomes of pregnancy due to COVID-19
Following pregnancy outcomes may occur due to COVID-19:
Precautions to be followed by pregnant woman
A pregnant woman should follow the following precautions:
In addition to physical health factors, mental health should also be managed in pregnant women so as to not have an effect on the child. While more research is required, currently pregnant women are considered to be at a greater risk of COVID-19. By making use of the available information, pregnant women or new mothers can keep themselves and their child safe.
FAQs:
Pregnancy and Delivery while being tested COVID positive
A big question in recent times has been this: Is it possible to have a safe and healthy delivery even if the pregnant mother is tested positive for COVID? What should the expecting parents expect? What are some safeguards put in place to ensure the safety of the baby and parents? We throw light on the most commonly asked questions.
Is natural delivery possible even if I am COVID positive?
Yes, it is possible. At Bloom, we have delivered babies the natural way when the mother was COVID-positive. Our first preference is for natural delivery. In cases of unforeseen complications, the mother may be advised to go for a C-section – sufficient information and advice will be shared with both partners in such cases.
If I test positive for COVID before my delivery, will my child be born with the sickness?
In our experience, in most cases, newborns do not carry the corona virus from the mothers. In rare cases, they may exhibit symptoms of COVID infections after some time, but this is treatable. Also, we do not have proof that the child’s physical and mental development (while in the womb) may be affected if the mother is COVID positive.
To be on the safe side, if the mother has tested positive for the COVID, we do recommend testing the newborn for virus as well. The tests are carried out 24 hours and 48 hours after the baby’s birth. The tests will not be painful or hurt your baby in any way.
Is it possible for me to visit my baby (COVID POSITIVE) if a stay in NICU is needed?
If the mother is also COVID positive she allowed to see and nurse the baby. If the mother is not COVID positive, she is not encouraged to be with the baby. The baby is given expressed mother’s milk till the baby recovers from COVID.
If I am COVID positive even after delivering the baby how do I handle the situation?
You will be a happy parent! ? The pandemic does not in any way take away the joy arising from the miracle that is birthing a child – so enjoy every moment of your pregnancy and parenting journey.
You will be given sufficient guidance and advice about caring for your child post-delivery by our doctors. Mothers who have tested COVID-positive have been advised to breastfeed their child – this will help pass on essential anti-bodies from the mother to the baby. You would, however, need to wear a cloth mask at all times while tending to your child. Depending on your symptoms, you will be advised on the measures you need to follow once you are back home.
If I am COVID positive, can my partner be in the delivery room when I’m delivering?
No. If your partner is not COVID positive he will not allowed to be present in the delivery room. If he is also positive then he will be allowed to be the delivery room.
If I am COVID positive and have just delivered, how long would I have to stay at the hospital? Can I go home and be self-quarantine while I recover?
You may have to stay till the COVID symptoms are safe for you to go home. This will be advised by your physician and a home quarantine protocol will be taught. All precautious regarding medication and baby care guidelines will be given on discharge.
