Coronavirus: how will it affect my pregnancy, my unborn child and my baby?

Dr Philippa Kaye agrees, adding: "It seems that, like the rest of the healthy, young population, if there are no underlying health conditions, your symptoms are likely to be mild to moderate."

Research from the University of Oxford, in collaboration with the RCOG (May 11 2020) supports the view that "pregnant women are at no greater risk of severe illness than the non-pregnant population". But the research also finds that:

• Over half (55%) of the small number of pregnant women who have been admitted to hospital with coronavirus symptoms were from a black or minority ethnic (BAME) background. In light of this, RCOG say they are updating their guidance "to reflect that BAME women should be told at each contact with a health professional that they may be at higher risk of complications of coronavirus, and advised to seek help early if they are concerned about their health".
• The majority of pregnant women who did become severely ill were in their 3rd trimester of pregnancy. This, say the researchers, "emphasises the importance of social distancing" for women in the last few months of pregnancy (see Do I need to take special precautions if I'm pregnant? below).

I don't have symptoms of coronavirus. Is it still OK to go to my antenatal appointments and scans?

Yes, if you have a scan or appointment due soon but RCOG advise that you contact your maternity team first, as appointments may be subject to change if, for example, there are fewer staff available.

If you don't have an appointment or a scan for a while yet, you should wait to hear from your maternity team. There may be a need to reduce the number of antenatal appointments you have. You may also be asked not to bring children to your appointments.

If you have an appointment cancelled or delayed and aren't sure when your next one will be, you should let your maternity team know by calling the contact numbers given to you when you had your booking-in appointment.

Could coronavirus affect my unborn baby? Can it be transmitted through the placenta?

The current scientific thinking on this has changed over recent weeks.

Initial research from China, published in March 2020¹ indicated no evidence that the virus can pass to your baby through the placenta or during childbirth – this is called 'vertical transmission'. But, according to the latest guidance from RCOG (June 19 2020), it's now thought that vertical transmission is probable.

But, the RCOG experts go on to say, in their Q&As about coronavirus infection and pregnancy:

It is important to emphasise that in all reported cases of newborn babies developing coronavirus very soon after birth, the babies were well. Given current evidence, it is considered unlikely that, if you have the virus, it would cause problems with your baby’s development, and none have been observed currently. There is no evidence to suggest an increased risk of miscarriage.

Is there any evidence of a risk of premature birth if you have coronavirus ?

It's certainly true that pregnant women with COVID-19 seem to have a higher premature birth rate than the UK average: latest studies suggest 1 in 5, compared to 1 in 13. But it's still too early for experts to have a clear answer on why.

"Around the world, some women who tested positive for coronavirus have had premature babies," says Dr Philippa. "However it isn't clear if the virus caused the premature birth or whether doctors made the decision for the baby to be born early because the mum-to-be was unwell."

And looking at the latest (18 May 2020) study of 427 pregnant women admitted to hospital between 1 March and 14 April 2020, RCOG adds: "Outcomes for babies born to mothers with COVID-19 were mostly good. Although almost 1 in 5 were born prematurely and were admitted to a neonatal unit, fewer than 20 babies were born very premature (when their mothers were less than 32 weeks pregnant)."

Once my baby is born, should I stay at home to reduce the risk of either of us getting coronavirus?

The current guidance does not suggest to do this currently, although we are hearing from new mums who post in our MadeForMums Chat forum that some of them are being told not to introduce their baby to the new grandparents for 12 weeks. We will update/confirm these details once we hear anything official.

Should I avoid having visitors while my baby is newborn to reduce the risk of contracting coronavirus?

"It would be sensible to avoid contact with people who are unwell or who have been exposed to the virus and to follow the general advice to minimise spread of disease," says Dr Andy. "These include regular, effective hand-washing and safe sneezing/coughing practices."

Is it still safe to breastfeed? Can coronavirus be transmitted through breastmilk?

"There currently isn't evidence that you can pass on the virus through breastmilk," says Dr Philippa.

The RCOG advises continuing breastfeeding, stating, "At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk."

If you have coronavirus yourself, you're currently advised to discuss the risks and benefits of breastfeeding with your GP or midwife. The main risk of infecting your baby is not from your breastmilk, but from the fact that you have close contact between you and your baby and may pass the virus on through airbone droplets.

According to the RCOG, if you have coronavirus and want to breastfeed your baby, the following precautions are recommended:

• Wash your hands before touching your baby, breast pump or bottles
• Wear a face-mask for feeding at the breast
• Follow recommendations for pump cleaning after each use
• Consider asking someone who is well to feed expressed breast milk to your baby.

If you're feeding your baby with expressed milk or formula, the advice is to make sure you carefully follow sterilisation guidelines available on the NHS website.

Is my new baby more at risk of getting coronavirus than adults?

"There is no data to suggest children are at greater risk of catching coronavirus," explains Dr Andy. "In fact, most serious cases have occurred in the elderly and children have generally had milder disease. Young babies are more vulnerable to infections generally, but there is not yet the data to suggest they are at increased risk of serious disease caused by coronavirus."

What symptoms will my baby have if they get coronavirus (COVID-19)?

The symptoms would be the same as in adults, explains Dr Andy.

• Fever
• Cough
• Runny nose
• Potentially difficulty in breathing
• Diarrhoea has also been reported in children

Dr Philippa offers this important reminder: "Any newborn who develops a fever up to 28 days of age must always be seen by a medical professional - so please do contact 111 if this occurs."

Reference

^{1. Novel coronavirus infection and pregnancy, H Yang et al. Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.22006}

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