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What pregnant women need to know about COVID-19
by Aarti Pole, CBC News
Mar 22, 2020

Obstetrics professor Dr. Jon Barrett answers some of questions about potential impacts of coronavirus

Health-care professionals and researchers are learning new information every day about COVID-19 and its effects on the young, the old and those considered to be at risk.

For pregnant women, there could be additional concerns and uncertainty over the potential impact of the coronavirus for them and their babies.

According to the Society of Obstetricians and Gynaecologists of Canada, pregnant women who have lower respiratory tract infections "often experience worse outcomes" compared to women who aren't expecting a baby because of physiological changes that occur in pregnancy.

Dr. Jon Barrett is the head of maternal fetal medicine at Sunnybrook Health Sciences Centre in Toronto and a professor of obstetrics and gynecology at the University of Toronto. He spoke to the CBC's Aarti Pole regarding what pregnant women should know about COVID-19.

Are pregnant women more susceptible to COVID-19?
It looks like pregnant women are not more at risk, probably because this virus does not have the same predilection to go down deep into the lungs as SARS or MERS. We're getting new data all the time so it could change. I'd be surprised if the risks to the mother change because there was quite a lot of exposure to moms and we got the mortality rate, and the mortality rate for the pregnant moms who are exposed was zero whereas in the non-pregnant population it was higher than that.

Should pregnant women be taking greater precautions in terms of self-isolation?
There does not seem to be any reason for a pregnant woman to be more or less concerned than someone who is not expecting.

(EDITOR'S NOTE: Some health authorities, however, are recommending women at certain stages of pregnancy get tested for the virus. Vancouver Coastal Health, for example, has recently added women in their third trimester who exhibit COVID-19 symptoms to the list of people who should be tested for the virus.)

Is there any evidence of transmission from the mother to the fetus?
Not yet is there evidence of that — but this could be different tomorrow as we continue to get new information. I wouldn't be surprised if it does come up simply because it's a virus and most viruses can cross the placenta. That doesn't change that it probably isn't common. If it was common, we would have found it already, and it doesn't seem to change the fact that if it's there, the babies seem to do well.

How do newborns handle the virus?
It seems to be that [newborns] do very well and children seem to do very well for some reason, better than adults.

Could contracting COVID-19 lead to long-term respiratory illness for newborns?
At this point, we really don't know.

Can you breastfeed if you have COVID-19 or are presenting symptoms?
Right now, the guidelines for Canada say that breastfeeding is allowed. The Chinese did not [allow it]. Take precautions like handwashing, don't cough or sneeze on your baby etc. Be more alert than regular contact precautions, but you can still breastfeed. But if you're positive [for COVID-19], wear a mask while breastfeeding.

If you are presenting symptoms and go into labour, what is the protocol?
You would be admitted, you would be managed with the proper precautions, the caregivers would all be masked, the person that came with you would be masked and would not be allowed out of your room. You would deliver the baby and the baby would stay with you as long as your baby is well.

Are new moms being discharged sooner to make space in hospitals?
No, you won't be discharged sooner. In a disaster scenario, it's not impossible to think that could happen depending on the demand for the hospital beds, but right now that's not foreseen.
 
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