Virus disrupts pregnancy plans
COVID-19 raises anxiety and questions
Some pregnant women fear giving birth with no loved ones by their side. Others worry about getting sick with COVID-19 and not being able to hold their newborns. The coronavirus pandemic has injected anxiety and uncertainty to an already stressful time and while science about risks is mostly reassuring, doctors want clearer answers too.
“There is very limited information available,” said Dr. Leana Wen, a George Washington University public health specialist. She wants answers as a physician and as a patient - Wen is pregnant and due to give birth to her second child any day. Her greatest fear is developing a COVID-19 infection or symptoms that would force her to be separated from her newborn for days or weeks.
“I would only be able to see my baby through a glass window,” said Wen, former Baltimore health commissioner. “That’s the one that gives me nightmares.”
To help provide answers, the University of California, San Francisco last week started the first US registry of COVID-19 infected or exposed pregnant women. At least 60 women have enrolled so far.
Not all have confirmed cases. Women who turn out not to be infected will remain in the registry as a comparison group. The more women in the registry “the more quickly we can provide the answers,” said Dr. Vanessa Jacoby, who heads the effort.
Complications
The big questions include: Are pregnant women more likely than others to become infected and to develop complications? Preliminary evidence suggests no.
There is also no definitive evidence that the virus can be transmitted from mother to fetus during pregnancy, although three small and preliminary studies from China published last week raised that possibility. One paper in JAMA Pediatrics included 33 infants born to infected women; only three babies tested positive, two days after birth, and developed symptoms including pneumonia. All three recovered.
It’s likely their mothers transmitted the disease during or after birth, not during pregnancy, said Dr. David Kimberlin, a pediatric infectious disease specialist at the University of Alabama at Birmingham.
“The numbers are too small to make any conclusions” about how often infants become infected or how sick they become, Kimberlin said. Guidance from the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine says pregnant women with COVID-19 should be considered high-risk patients. That’s because pregnant women who develop flu or other respiratory infections caused by related viruses face increased risks for complications from those illnesses, including premature births and certain birth defects. (AP)