Although much is still unknown, emerging data, suggests that COVID-19 may activate blood clotting pathways and can lead to excessive inflammation that can cause damage to tissues throughout the body, making a pregnant woman more at risk for complications during the pregnancy and postpartum periods. “Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth.”iv
Although there are cases reported of transmission of the virus from mom to baby in-utero or during the birthing process, the data are reassuring that this appears to be uncommon.ii Transmission to the baby is thought to occur primarily through respiratory droplets during the postnatal period when neonates are exposed to mothers, other caregivers, visitors, or healthcare personnel with COVID-19v. It is critical that appropriate precautions are taken after delivery to prevent the spread of the virus from the mother to the infant. At this time, experts say there is no need to change the timing or method (cesarean vs. vaginal) of delivery to decrease the risk of spread to the infant.vii Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are a few reports of newborns with severe illness.i In the rare case of infant death, it has not been determined if it was due to the virus or other underlying (original, or already existing) conditions.
Current data [gathered through case reviews and the Perinatal COVID-19 Registry] suggest that approximately 2-5% of infants born to women with COVID-19 near the time of delivery have tested positive in the first 24-96 hours after birth. [It is] not yet know[n] if any of the newborns reported to the American Academy of Pediatrics (AAP) Registry have become ill at home following hospital discharge. There are few case series of pediatric COVID-19 published to date, but clinicians and families should be aware that there are published reports of infants requiring hospitalization before one month of age due to severe COVID-19 infection.vi
Although there is much that is still unknown about this virus and its effect on perinatal women and infants, what we do know tells us how extremely important it is for you and your baby to have frequent follow-up with your medical provider/s during the pregnancy, postpartum, and newborn periods.
A nationwide study is taking place now to help pregnant women and the medical community learn more about how COVID-19 effects pregnant women and their newborns. If you are pregnant or recently pregnant and are under investigation for COVID-19 or have been confirmed to have COVID-19, you are encouraged to participate in this study. To learn more about the study and how to enroll, please visit the PRIORITY Study website.
Updated: November 18, 2020
i Centers for Disease Control and Prevention; Coronavirus Disease 2019 (COVID-19); Pregnancy, Breastfeeding, and Caring for Newborns; updated November 3, 2020; retrieved from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
ii Centers for Disease Control and Prevention; Coronavirus Disease 2019 (COVID-19); Pregnancy Data; updated November 13, 2020; retrieved from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/special-populations/pregnancy-data-on-covid-19.html
iii The American College of Obstetricians and Gynecologists; Clinical Guidance; Practice Advisory; Novel Coronavirus 2019 (COVID-19); updated July 1, 2020 with summary of key updates made November 6, 2020retrieved from https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019
iv Centers for Disease Control and Prevention; Coronavirus Disease 2019 (COVID-19); Caring for Pregnant Women; revised May 20, 2020; retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html
v Centers for Disease Control and Prevention, Coronavirus Disease 2019 (COVID-19), Caring for Newborns; updated May 20,2020; retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-newborns.html
vi American Academy of Pediatrics; Critical Updates on COVID-19; Clinical Guidance; FAQs: Management of Infants Born to COVID-19 Mothers; updated 7/22/20; retrieved from https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers/
vii The American College of Obstetricians and Gynecologists; Patient Resources; FAQ; Coronavirus (COVID-19); Pregnancy and Breastfeeding; updated November, 2020; retrieved from https://www.acog.org/patient-resources/faqs/pregnancy/coronavirus-pregnancy-and-breastfeeding