Based on continuing medical research, some facts have come to light about Coronavirus and pregnancy

Pregnant women who are

• Overweight or obese
• Age > 35
• Have diabetes
• Have hypertension or High BP

Have a higher chance of getting more severe illness if they catch Coronavirus infection.

If a pregnant woman catches COVID, she is more likely to be admitted in the ICU than the general population.

Pregnant women are considered to have lower immunity and thus are considered the vulnerable group generally, so are advised to be more careful with precautions and general measures like 

• staying home, social distancing, 
• Frequent hand washing with alcohol based hand rub or soap and water
• Practicing respiratory hygiene, covering your mouth with your bent elbow if coughing or sneezing 

But they should continue their antenatal visits and should ensure a healthy diet, exercise and stress free lifestyle.

It is still unknown if a pregnant lady can transmit the virus to her fetus during pregnancy or during breastfeeding.Covid virus has not shown to increase the risk of miscarriage, or of any anomaly in the fetus if the mother gets the infection during pregnancy.Studies did show an increase in the chances of preterm labour.

Pregnant women with COVID can still try for a normal delivery. Cesarean section is usually done only if medically justified.

The treatment of COVID in pregnancy is mainly supportive, and is similar to the treatment otherwise. Some antibiotics shown not to be safe in pregnancy should be avoided. Pregnant women need thromboprophylaxis, or medicines that help in prevention of blood clotting in pregnancy.

A pregnant woman who has covid during the time of delivery can choose to breastfeed or room in with her baby after a discussion with her gynecologist and pediatrician according to WHO. A good option is to express the breast milk and a COVID negative family member can provide it to the baby. Or feeding with the mask for 15-20 minutes can also be done.

Vaccination

COVID vaccine is currently not recommended in pregnancy and breastfeeding mothers in India. This is because the vaccine has not yet been tested in pregnant women in India.

However internationally, the vaccines are being offered to pregnant women considered as high risk after a discussion with their gynecologist.

The vaccines are not Live vaccines, they are either component vaccines or made with the dead virus, so theoretically they can’t harm or cause covid infection in the individual vaccinated.The precaution for pregnant women is mainly because of the lack of trials yet. Eventually the guidance may change with time, as we get better data on its safety.

Planning Pregnancy

Women planning pregnancy should have a discussion with their gynecologist about the risks and consequences. They may have to delay planning, if they’ve taken the vaccine.

Otherwise, in 2021, hopefully with the decline of the pandemic, it should be safe to plan pregnancy.

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How does COVID-19 affect pregnant women?

Researchers are still learning how COVID-19 affects pregnant women. A report released in June 2020 looked at whether pregnant women might be at increased risk of getting very sick from COVID-19. This report from the Centers for Disease Control and Prevention (CDC) notes that:

• Pregnant women with COVID-19 may be more likely than non-pregnant women with COVID-19 to need care in an intensive care unit (ICU) or need a ventilator (for breathing support).
• Pregnant women who are Black, Hispanic, or Asian may have a higher risk of severe illness or need ICU care more often than other pregnant women. This is likely caused by social and economic inequity, not biological differences.

Although the risk of needing more care in the hospital and having more severe illness may be increased, the overall risk of these outcomes is still low for pregnant women. Also, it’s important to know that the report suggests the risk of death is not higher for pregnant women with COVID-19 than for nonpregnant women with COVID-19. 

What should pregnant women do to avoid the coronavirus?

Pregnant women should take steps to stay healthy, including

• keeping your prenatal care visits 
• limiting contact with other people as much as possible
• staying home as much as possible
• staying at least 6 feet away from other people if you need to go out 
• wearing a mask or cloth face covering in public and any other needed protection while at work 
• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60 percent alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth 
• having a good stock of essential supplies, including at least 30 days of any medications (so you don’t have to go out as often)

What is corona virus?

Corona viruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

Can the virus that causes COVID-19 be transmitted through the air?

Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air. See the previous answer on “How does COVID-19 spread?”

What is COVID-19?

COVID-19 is an infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019.

Can CoVID-19 be caught from a person who has no symptoms?

The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true in the early stages of the disease. It is therefore possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don’t feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

Can I catch COVID-19 from the feces of someone with the disease?

The risk of catching COVID-19 from the feces of an infected person appears to be low. While initial investigations suggest the virus may be present in feces in some cases, spread through this route is not a main feature of the outbreak. The ongoing research on the ways COVID-19 is spread and will continue to share new findings. Because this is a risk, however, it is another reason to clean hands regularly,after using the bathroom and before eating.

How does COVID-19 spread?

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose, or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.

How likely am I to catch COVID-19?

The risk depends on where you are – and more specifically, whether there is a COVID-19 outbreak unfolding there. For most people in most locations, the risk of catching COVID-19 is still low. However, there are now places around the world (cities or areas) where the disease is spreading. For people living in, or visiting, these areas the risk of catching COVID-19 is higher. Governments and health authorities are taking vigorous action every time a new case of COVID-19 is identified. Be sure to comply with any local restrictions on travel, movement, or large gatherings. Cooperating with disease control efforts will reduce your risk of catching or spreading COVID-19. COVID-19 outbreaks can be contained and transmission stopped, as has been shown in China and some other countries. Unfortunately, new outbreaks can emerge rapidly. It’s important to be aware of the situation where you are or intend to go.

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