Even in the best of circumstances, pregnant women and their families often experience some degree of anxiety. Women who are pregnant or who have recently given birth have concerns about COVID-19, from questions about exposure and social distancing to transmission of the illness. Marc Incerpi, MD, chief of maternal-fetal medicine at Keck Medicine of USC, answers questions about pregnancy during the COVID-19 pandemic.
Are pregnant women more at risk of getting COVID-19 than other women?
Pregnancy suppresses a woman’s immune system to a certain extent. However, this does not mean pregnant women are more susceptible to contracting COVID-19 than women who are not pregnant. Rather, if they do become infected, they may have a greater risk of more severe respiratory complications. They also face a similar, higher risk with other conditions like the common cold or the flu.
The third trimester can be most concerning because of the physiologic changes that occur in all pregnancies. As the pregnancy advances and the uterus and fetus get bigger, the diaphragm is constricted and doesn’t function as well. Therefore, respiratory illnesses such as COVID-19 can have a greater impact.
What are pregnant women most worried about regarding the coronavirus right now?
Most expectant mothers are concerned about getting infected, just like everyone else. The shutdowns, quarantines, “safer at home” measures and cancellation of appointments have led us to change the way we deliver quality medical care throughout their pregnancy.
At Keck Medicine of USC hospitals and locations, we’ve cancelled all non-essential appointments and procedures and are using telemedicine to maintain contact. We recommend that patients buy an at-home blood pressure monitor to provide that data to their physician during virtual visits.
Currently, the maternal-fetal medicine offices are not allowing significant others to accompany pregnant patients to the waiting or ultrasound rooms. This is to ensure the safety of everyone, including office staff, physicians and patients.
Are there special risks to the baby in the womb?
We believe that the risk of infection for babies in the womb of being born with coronavirus is extremely low. There was a case study of a baby born in Wuhan whose mother had COVID-19. The baby tested negative for the virus but he had antibodies in his blood, suggesting there was some form of vertical transmission, which occurs when a mother passes a disease on to their newborn.
Can the coronavirus be transmitted from mother to baby through touch or breastfeeding?
The coronavirus is not present in breast milk. However, it can be transmitted to the baby during breastfeeding if the mother is infected via close personal contact. In order to lower that risk, women can continue to breastfeed and wear a facemask or may choose to express milk via breast pumping so that an uninfected individual can bottle feed the baby. It is important to stress that hand-washing is essential, as is thoroughly cleaning and washing all bottle and/or breast pump parts. We are still encouraging breastfeeding given its many benefits, including providing the baby with antibodies to help fight infection.
— Leigh Hopper and Gabriella Robinson