Mar 03, 2020 12:00 AM

Author: Kylene Metzger

Women are more susceptible to some viral illnesses during pregnancy, still little is known about how coronavirus, or COVID-19, impacts an expectant mother and her baby. The Centers for Disease Control and Prevention (CDC) consider women to be part of an at-risk population for severe illness in the case of some viral infections, such as influenza. We do not currently know if pregnant women are more susceptible to COVID-19, nor if they are at increased risk for severe illness relative to the general population.

The CDC believes mother-to-child transmission during pregnancy is unlikely. “Vertical transmission or transmission from mother to baby before, during, or after immediately delivery has not been shown for COVID-19, but it can’t be entirely ruled out,” says Erin Clark, MD, Division Chief of Maternal Fetal Medicine at University of Utah Health. Results from the limited number cases of infants born to mothers with COVID-19 have shown newborns tested negative for the virus. However, the child is vulnerable to COVID-19 through person-to-person contact once born.

Transmission of COVID-19 after birth is a concern. To reduce the risk of transmission of the virus, the CDC recommends healthcare facilities to consider temporarily separating the newborn and the mother who has been confirmed with COVID-19 or under investigation for the virus. Separation should be made on a case-by-case basis in consultation with a provider.

Pregnancy loss, including miscarriage and stillbirth, has been reported in cases of infection with other related coronaviruses such as SARS-CoV and MERS-CoV, according to the CDC.  “If moms get really sick, they are at increased risk for preterm birth, low birth weight and pregnancy loss,” says Clark. “Those outcomes may not be directly related to fetal infection with the virus, but rather the fact that the mother is so ill.” For COVID-19, there is no information at this time on pregnancy outcomes.

It is unclear whether breastfeeding is safe during maternal infection with COVID-19. Testing so far has shown no evidence of the virus in breast milk in women infected with COVID-19. However, transmission of the virus from mom to baby after birth remains a concern. To reduce the risk of transmission through respiratory secretions, precautions such as physical separation, facemasks and excellent hygiene should be considered according to the CDC. Even if separated, infected mothers can still provide expressed breast milk to maintain their supply and provide the benefits of breastmilk to their newborns.

A mother with confirmed COVID-19 or is under investigation for the virus should take precautions when breastfeeding to help prevent the spread of the virus to her infant. This includes handwashing before touching the infant and wearing a face mask while feeding. If a mother is using a breast pump, the mother should wash her hands before touching the pump or bottle parts and then properly clean the products afterwards.

Pregnant women should use preventative measures to avoid infection:

  • Avoid close contact with people who are sick.
  • Stay at home when you are sick.
  • Cover your coughs and sneezes.
  • Clean frequently touched surfaces and objects.
  • Wash your hands often with soap and water for at least 20 seconds.

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