The current pandemic of coronavirus disease (COVID-19) caused by the extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading at an unprecedented rate globally. Pregnant women and their foetus are a high-risk group during outbreaks of infectious disease. Study shows that pregnant women with suspected or confirmed COVID-19 seen at a hospital are less likely to suffer fever or muscle pain, but if they develop serious illness, they are more likely than non-pregnant women with COVID-19 to require intensive care.
Should pregnant women be tested for COVID-19?
Based on WHO recommendations, pregnant women with symptoms of COVID-19 should be given priority for testing. They may need specialised care if they have COVID-19.
Are pregnant women at risk of developing severe disease due to Covid-19?
Pregnant women can be seriously affected by certain respiratory infections because of changes in their bodies and immune systems. It is therefore critical that they take precautions to protect themselves against COVID-19 and to alert their healthcare provider of potential symptoms including fever, cough or trouble breathing. Existing data shows that individuals who are non-white, aged, who are overweight and have a pre-existing medical condition are more vulnerable to serious illness. According to findings, pregnant women with COVID-19 who have pre-existing medical conditions, such as diabetes or chronic high blood pressure, or who are older or overweight, more likely to suffer severe health complications due to COVID-19.
What are the complications of Covid-19 in pregnancy?
Research findings show that pregnant women with COVID-19 were more likely to give birth prematurely. The results also suggest that one in four of all babies born to women with COVID-19 were admitted to a neonatal unit, but there is a lack of information on the causes of preterm births or signs of admission to neonatal units among these babies. However, stillbirth and death rates for new-borns were low. Existing data also do not suggest an increased risk of miscarriage or early pregnancy loss in pregnancies with COVID-19 .
Can COVID-19 be passed from a woman to her unborn baby via vertical transmission?
According to the World Health Organization (WHO), they could not confirm that a pregnant woman with COVID-19 can pass the virus to her foetus or baby during pregnancy or delivery. To date, no active virus has been found in samples of fluid around the baby in the womb or breastmilk. Research data also shows that evidence to support vertical transmission of COVID-19 is extremely low. Another study suggested that effective implementation of protection measures during delivery, including a negative-pressure delivery room, may help prevent the infant from acquiring SARS-CoV-2 infection.
Do pregnant women with suspected or confirmed COVID-19 need caesarean section to give birth?
Absolutely not. WHO recommendation is that Caesarean section can only be done if medically justified. The mode of birth should be individualised and based on the choice of a woman in addition to obstetric indications.
If you are tested positive for COVID-19, can you touch, hold and breastfeed your baby?
Yes, you can. It is important to wash your hands before and after touching your baby. Mothers with symptoms of COVID-19 are advised to wear a medical mask during any period of contact and to have a separate room with your newborn.Close contact and early, exclusive breastfeeding help the child to thrive. Currently, there is extremely limited evidence that the virus may be present in breast milk and there is no evidence that it is transmitted through breast milk. Given how the virus spreads, study recommends that mothers with COVID-19 should be able to breastfeed their babies safely, although they should practice hand hygiene and wear a face mask. This will help minimise the exposure of infants to the virus. If you choose to express breast milk, you need to use your own breast pump and one not shared with anyone else. Wearing a mask during expression is a must. Please wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts, and before expressing breast milk. Once done, you have to follow recommendations for proper pump cleaning to clean all parts of the pump that come into contact with breast milk.
Caregivers should wash their hands for at least 20 seconds before touching your newborn baby. Use a hand sanitiser with at least 60% alcohol if soap and water are not available. If the caregiver is living in the same home or has been in close contact with you, they may have been exposed. They should wear a mask when they're within six feet of your newborn for the whole time you're in isolation.
How can you keep your baby healthy and safe?
Face shield or mask is not allowed on your baby as children younger than two years of age should not wear masks. A face shield may increase the risk of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation. Babies move around, and their movements may cause the plastic face shield to block their nose and mouth, or cause the strap to strangle them.
The birth of a new baby is a great moment that usually brings families together to celebrate and support the baby and the new mother. However, before allowing or inviting visitors to your home or near your child, consider the risk of COVID-19 to yourself, your child, the people who live with you, and visitors. Limiting the number of visitors to see a new baby is crucial as bringing in new people who do not live with you can increase the risk of getting Covid-19 infection. Practice six feet of distance between your baby and people who do not live in your household.
For more information on Covid-19 in pregnancy, visit:
Centres for Disease Control &Prevention
Obstetrical & Gynaecological Society of Malaysia
References
Pradip Dashraath, Jing Lin Jeslyn Wong, Mei Xian Karen Lim, Li Min Lim, Sarah Li, Arijit Biswas, Mahesh Choolani, Citra Mattar, Lin Lin Su,Coronavirus disease 2019 (COVID-19) pandemic and pregnancy,American Journal of Obstetrics and Gynecology,222, Issue 6,2020,
Moreno, S., To, J., Chun, H., & Ngai, I. (2020). Vertical Transmission of COVID-19 to the Neonate. Infectious Diseases In Obstetrics And Gynecology, 2020, 1-5.
Wendy N. Phoswa, Olive P. Khaliq,Is pregnancy a risk factor of COVID-19?
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 252, 2020, pp. 605-609
Sonja A. Rasmussen, Denise J. Jamieson,Coronavirus disease 2019 and pregnancy, American Journal of Obstetrics and Gynecology, 2020
Zhang L, Jiang Y, Wei M, et al. [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. Zhonghua fu Chan ke za zhi. 2020 Mar;55(3):166-171
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