A letter from Dr. Evan Rosenbluth on pregnancy and COVID-19
Greetings from home. I hope that you are all safe, isolated and healthy. I am doing alright, hoping that California is being the country’s role model for staying in place and flattening the curve.
Of course, emotions run the gamut throughout the day: nervous, bored, punchy, stir-crazy, appreciative, terrified … sometimes all within a matter of minutes! Pandemics have run their course throughout history. The difference with pregnancy and COVID-19 is that it has never been this easy to travel, the world has never been so populated, and news has never disseminated so quickly.
Due to this, both the actual virus and the news of the virus travel at an unprecedented speed. Images of very sick patients and overloaded hospitals flood our news streams. The tidal wave of information can be terrifying, particularly, for all of our pregnant patients or patients who are actively trying to conceive. Our patients and their families are surely wondering, How will the virus affect my child? How will the virus affect me while I’m pregnant?
These thoughts are especially true on the heels of the Zika virus. The tragic effects that has on the developing child and newborns are terrifying and shocking. Because of the Zika outbreak in 2016, major organizations like the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention recommend not trying to conceive if there is a possibility of exposure to the Zika virus.
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There is reassuring news about pregnancy and COVID-19
This coronavirus (COVID-19) is a mutated virus, which makes it new to our planet. Since we have never seen it before, we do not know its effect on developing fetuses. However, we live in an age where data can be shared so quickly. There is some reassuring news when it comes to pregnancy and COVID-19.
On March 28, 2020, an article was published online that is, to date, the largest outcome study of pregnant women infected by COVID-19. Thirty-eight pregnant women infected by the virus and outcomes of their children were studied. Fortunately, no evidence of the virus was found in the babies, amniotic fluid, vaginal mucus, urine, feces, saliva, or breast milk. The authors concluded that, unlike other coronavirus studied before (SARS and MERS), there was no evidence of vertical transmission (transmission from mom to child). That is reassuring.
We know that other respiratory illnesses can have serious consequences for pregnant women, especially later in pregnancy. Because lung capacity is significantly diminished, respiratory infections in late trimester pregnant women can get very bad very quickly. We definitively know that there is an increased risk of severe sickness and death in pregnant women infected by influenza, SARS and MERS.
As of April 2, 2020, the American College of Obstetricians and Gynecologist , the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention have not issued any recommendations against trying to conceive during the active outbreak of COVID-19. Phew.
We are doing all that we can to reduce COVID-19 transmission
There is still much to learn about the virus. As of now, we only have outcome data from pregnant women exposed in the third trimester. We do not have any information about babies exposed earlier in pregnancy. We may find out in the future that earlier exposures may have an effect on babies and mothers, and recommendations for attempting pregnancy may change.
With that in mind, the best thing we can do is to keep doings we are doing: shelter in place, avoid contact with other people, maintain distance >6 feet if you have to be around others, covering mouths when coughing, and be vigilant about washing hands thoroughly and frequently. We can also take a bit of comfort in these reports that the vast majority of people infected with COVID-19 recover well, and, at this time, there is no evidence of increased risk to moms and their babies. We will keep you updated as new data come out.
Stay safe everyone. We will get through this!
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