Coronavirus: Can it affect your pregnancy and newborn?March 26, 2020 @ 3.44PM
By Dr Patricia Lim Su Lyn, Obstetrician and Gynaecologist,
KPJ Tawakkal Specialist Hospital. The first case of a 30-year-old pregnant woman who tested positive for Covid-19 after delivering her baby at the Pantai Hospital Laguna Merbok, Kedah has raised concern among expecting mothers – whether the disease would be passed on to the fetus or the newborn if the mother had contracted the disease.
While most cases of COVID-19 globally have evidence of human to human transmission, recent cases have appeared where there is no evidence of contact with infected people. This virus appears to spread readily, through respiratory, fomite or faecal methods. Only one case of possible vertical transmission (transmission from mother to baby antenatally or intrapartum) has been reported. The fetus is unlikely to be exposed during pregnancy. A case series published by Chen et al tested amniotic fluid, cord blood, neonatal throat swabs and breastmilk samples from Covid-19 infected mothers and all samples tested negative from the virus. Furthermore, in a different paper by Chen et al, three placentas of infected mothers were swabbed and tested negative for the virus. Transmission is therefore most likely to be as a neonate. There is currently no evidence concerning transmission through genital fluids. Abnormalities or risk of autism Meanwhile, Dr Premitha Damodaran Obstetrician and Gynaecologist at Pantai Hospital Kuala Lumpur explained that the virus may affect pregnant mothers as a bad flu. “The fetus may not be affected, however, the mother will feel poorly during the illness, so mothers need to rest, drink, have a healthy diet and keep clean. “There is also no effect known on abnormalities in baby or increasing risk of autism. “Mothers do not transmit to babies. No known cases thus far according to the Centers for Disease Control and Prevention (CDC). Sometimes, there is a transient transfer which is insignificant,” she added. Nevertheless, Premitha advised mothers to practice good hygiene, be healthy, stay away from crowds and to continue to breast feed as breast feeding protects against numerous infections. In ‘Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study’ published by The Lancet on March 24 - the outcomes of the pregnant women were good. The paper cited examples of seven women who were admitted to the Tongji Hospital from Jan 1, to Feb 8, 2020. The patients were 29 to 34 years of age with a mean gestational age of 39 weeks. Six patents had fever while one had cough, one had shortness of breath and diarrhoea. All the patients had caesarean section within 3 days of clinical presentation. The study concluded that there were no intensive care unit admissions for mothers throughout the study period, including before and after delivery. At the end of follow-up on March 12, 2020), all patients had been discharged from the hospital per the following discharge criteria: body temperature returned to normal for more than 3 days; respiratory symptoms improved significantly; pulmonary imaging showed a significant improvement in acute exudative lesions; and nucleic acid test of respiratory specimens such as results of sputum and nasopharyngeal swabs were negative twice in a row (sampling interval ≥24 h). It also noted that the neonatal birthweights and Apgar scores of the infants were normal. Four infants were taken home and were not tested for SARS-CoV-2; no fever, pathological jaundice, or other symptoms were reported during the follow-up call at 28 days after birth. |
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