The pandemic has been ongoing for a long time, but our lives do not stop. We continue to go about our daily routines, working, providing for our families, and even planning for pregnancy. What are the particularly risky aspects we should consider during this historic time? It may not be the best time to have a baby, but it could also be the ideal moment to start a family. So how can we prepare?

1. Can COVID-19 be transmitted from a pregnant woman to her fetus?
Currently, it does not appear that most pregnant women infected with COVID-19 can directly transmit the virus to their fetus. There have been a few cases where the virus was found in amniotic fluid, but it is unclear whether the baby was infected while in the womb or shortly after birth.

2. What risks are associated with pregnant women infected with the coronavirus?
Initial data did not show that pregnant women are at a higher risk of infection or serious medical issues compared to non-pregnant individuals. The rate of infection was similar to that of non-pregnant people. However, recent research from the Centers for Disease Control and Prevention indicates that pregnant women with COVID-19 are more likely to require intensive care and oxygen therapy. Fortunately, the mortality rate is not high. While this information may be alarming, the overall health risks for pregnant women infected with the virus are relatively low and may even be less dangerous than other respiratory illnesses.

3. What risks does a pregnant woman infected with the coronavirus pose to her baby?
If a mother is infected with COVID-19 and exhibits mild symptoms while receiving appropriate treatment, it seems that her baby's health is not significantly affected. However, if the mother's symptoms are severe, her health can play a crucial role in the baby's health and the timing of delivery. A decline in the mother's health may increase the risk of preterm birth, although this can vary from case to case.

4. What measures are hospitals currently implementing regarding childbirth?
The situation varies from state to state and even from hospital to hospital. Most hospitals are allowing only one additional person in the delivery room, considering the emotional well-being of the pregnant woman. Some hospitals do not allow any visitors, while others permit family members but impose strict limits on the number and duration of visits. It is best to check with the hospital as the due date approaches to understand their policies. Currently, hospitals are managing newborns born to mothers infected with COVID-19 by separating them from other babies to prevent potential virus transmission. Giving birth during the pandemic does not increase the risks associated with childbirth, especially if the mother is healthy.

5. Can a mother infected with the coronavirus breastfeed after giving birth?
Yes, a mother who tests positive for COVID-19 can breastfeed. The virus is not transmitted through breast milk. In fact, breast milk may contain antibodies that can help provide immunity to the baby. Therefore, breastfeeding is not only possible but recommended. However, the infected mother should take precautions to prevent virus transmission, such as washing her hands, wearing a mask, and maintaining a distance of at least six feet from the baby whenever possible. If safety measures are in place to minimize the risk of transmission, the baby can stay in the same space as the infected mother.

6. What happens if a baby contracts the coronavirus?
Most babies who become infected do not experience significant problems and do not show severe symptoms. Respiratory symptoms are usually mild and resemble those caused by the flu. However, since there can be serious cases among newborns infected with the coronavirus, it is advisable to take them to a medical facility for further evaluation. A recent study of 25 newborns infected with COVID-19 found that only three exhibited severe symptoms, two required intensive care, and one needed oxygen therapy.

For additional information, please visit the following website: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers/
Sources: (1) Ellington S, Strid P, Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–775. (2) Liguoro, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020;179(7):1029. Epub 2020 May 18.

Written by Jennifer E. Cho, MD, FACOG