What is the effect of COVID-19 on pregnant women?
Pregnant women do not appear more likely to contract the infection than the general population. The large majority of pregnant women experience only mild or moderate symptoms. An estimated 74% of pregnant women with Covid-19 were asymptomatic.
Why have pregnant women been classed as moderate risk?
This is because pregnant women can be more at a higher risk from viruses like flu. It's not clear if this happens with coronavirus. But more severe illness appears to be more common in later pregnancy. In the UKOSS study, most women were hospitalised in their third trimester or peripartum period.
What is the potential impact of COVID-19 on pregnancy?
Maternal COVID-19 is associated with an approximately three times greater risk of preterm birth (17%). Maternal COVID-19 is also associated with an increased rate of caesarean birth. Again, from the UKOSS study, 59% of women had caesarean births; approximately half of these were because of maternal or fetal compromise.
What is the potential impact of COVID-19 on the baby?
It is reassuring that, despite over 31 million confirmed COVID-19 infections, there has been no significant reported increase in the incidence of congenital abnormalities. In the PregCOV-19 Living Systematic Review, there was no evidence of an increase in stillbirth or neonatal death among women with COVID-19, although there was insufficient available evidence to comment on the risk of miscarriage.
What are the risk factors for hospital admission for COVID-19 in pregnancy?
1. Black, Asian and minority ethnic (BAME) background
2. Being overweight (BMI 25–29 kg/m2) or obese (BMI 30 kg/m2 or more)
3. Pre-pregnancy co-morbidity, such as pre-existing diabetes and chronic hypertension
4. Maternal age 35 years or older
5. Living in areas or households of increased socioeconomic deprivation.
How will my Antenatal and Postnatal care be affected?
Antenatal and postnatal care should be regarded as essential and women encouraged to attend, while observing social distancing and infection prevention measures, as recommended by the UK Government. Women should be advised to continue their routine antenatal care, although it may be modified, unless they meet self-isolation criteria. It should be acknowledged that virtual appointments, particularly by telephone, may cause new challenges in relationship-building between women and healthcare professionals. Open access to day assessment and maternity triage services should be maintained. Women should be actively encouraged to attend if they have concerns about their or their baby’s wellbeing.
Is it safe to have my flu jab during the pandemic?
The influenza vaccination is still safe at all gestations of pregnancy and is recommended to protect both the woman and baby from the adverse effects of becoming seriously ill with flu during pregnancy.
How will my Labour care be affected?
Women with symptomatic confirmed or suspected COVID-19 are offered continuous fetal monitoring during active labour due to the possible increase in the risk of fetal compromise. Support and encourage women to have birth partners present with them during active labour and birth if they wish to do so, in accordance with local or national hospital policies. Ask birth partners to wear a face covering, remain by the woman’s bedside, not to walk around the ward/hospital and wash their hands frequently. Restrictions on visitors should follow local hospital policy. Having a trusted birth partner present throughout labour is known to make a significant difference to the safety and well-being of women in childbirth. The NHS has produced guidance to support the access of birth partners and other supportive adults to maternity services in England and Scotland.
Can I breastfeed if I have tested positive for COVID-19?
The long-term well-established benefits of breastfeeding are highly likely to outweigh any potential risks of transmission of the virus through breastmilk. A systematic review found that in 24 cases breastmilk tested negative for COVID-19; however, given the small number of cases, this evidence should be interpreted with caution.
All information is evidence based.
See below for resources and further reading:
RCOG (2020) Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-10-14-coronavirus-covid-19-infection-in-pregnancy-v12.pdf
RCOG (2020) Available at: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/
NHS (2020) Available at: https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/pregnancy-and-coronavirus/