Pregnancy and COVID-19

Pregnancy and COVID-19

Current evidence suggests that pregnant women are no more likely to catch COVID-19 than other healthy adults, and two thirds of pregnant women that do contract COVID-19 will show no symptoms at all.

There is growing evidence that pregnant women that do contract COVID-19 may be at increased risk of severe illness (compared with non-pregnant women), particularly in the third trimester. The risk of hospitalisation further increases if they:

  • are unvaccinated or not fully vaccinated
  • are of an ethnic minority background
  • have a BMI above 25 kg/m2
  • have a pre-pregnancy co-morbidity (such as diabetes or hypertension)
  • are of a maternal age ≥ 35 years
  • live with socioeconomic deprivation and work a ‘frontline’ public facing job

According to the Royal College of Midwives, the most common symptoms of COVID-19 in pregnancy are flu-like symptoms, cough and/or fever.

Those that test positive for COVID-19 at the time of birth are more likely to develop pre-eclampsia, more likely to need an emergency caesarean, have an almost doubled risk of stillbirth (though the number of stillbirths remain low) and may end up admitted to intensive care. Those who are symptomatic are two to three times more likely to have a premature birth, or be at an increased risk of their baby being small for their gestational age.

At present, it remains unclear whether pregnancy will be a factor that influences the proportion of women who experience ‘long COVID’ or a post-COVID-19 condition.

Importance of vaccination

The Joint Committee on Vaccination and Immunisation (JCVI) advise that pregnant women are at risk of COVID-19 and should be offered a vaccine as soon as possible.

Studies highlight that vaccination greatly reduces the risk of any negative side effects that occur following COVID-19 infection. Vaccination helps to protect both mums-to-be and their babies; protective antibodies are passed through the umbilical cord and through breast milk to help provide new-born immunity.

Women who have had two doses and a booster of vaccine are 88% less likely to be admitted to hospital with the omicron variant compared to those who remain unvaccinated.

If unvaccinated, the recommendation is to get the first 2 doses as soon as possible. Vaccination is safe at any stage of pregnancy; there is no need to delay until after giving birth.

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Covid and Baby

Current evidence suggests that vertical transmission (where the parent who contracts COVID-19 passes it on to the baby in their womb) is uncommon, and there have been no reports of any impact on baby’s development.

There is also no evidence to suggest that COVID-19 infection in early pregnancy increases the risk of miscarriage.

It is not always possible to isolate the cause of COVID-19 infection in new-born babies, and studies cannot attribute infection to mode of birth (i.e. vaginal birth or caesarean), feeding choice (i.e. breastfeeding or bottle), or whether parent and baby stay together. It is therefore important to continue care plans with baby’s best interest in mind.

Early attachment between mum (and/or other parent) and baby is critically important for a baby’s wellbeing and development. It is important to support new mothers in keeping their babies close so they may respond instinctively through gazing, stroking, skin-to-skin contact and talking; regardless of whether the mother or baby have suspected, probable or confirmed Covid-19.

[Note, the majority of new-born babies that develop COVID-19 very soon after birth remain in good health]

Breastfeeding

You cannot catch COVID-19 from breast milk, following natural infection or vaccination.

Breast milk is the best source of nutrition for most infants and provides protection against many illnesses (including for example COVID-19 when mum has been vaccinated).

If a baby is being breastfed by someone with suspected or confirmed COVID-19 they should be considered a close contact and quarantine for the duration of the lactating parent’s isolation. Precautions whilst breastfeeding should be taken, read more HERE.

Fertility

Infertility is not known to occur as a result of natural COVID-19 disease. Similarly, there is no evidence that COVID-19 vaccinations have any effect on the chance of becoming pregnant. There is also no need to avoid getting pregnant after being vaccinated.

Testing positive for COVID-19

If a parent-to-be tests positive for COVID-19 outside of the hospital setting, they should contact the maternity team to make them aware of the diagnosis (Tel: 20072266 ext. 2124/2125). This will allow, if required, the rearrangement of appointments.

Those with mild symptoms will be able to recover at home, much like the general population. Should more severe symptoms develop it may be necessary to seek further investigation. Women who are in their third trimester, or are high risk (as detailed above), should be particularly mindful of symptoms. Call 111 if in doubt (or 190 in an emergency) and be sure to inform them of a suspected or confirmed COVID-19 infection.

Anyone who goes into labour during self-isolation should call the maternity unit for advice.