Pregnant? Don’t panic, stay cautious of coronavirus
New study highlights need to be vigilant Jayne O’donnell
Cherie Smith’s been outside her Highlands Ranch, Colorado, home and car just once since March 26, and that was for an appointment with an obstetrician.
The office’s nurses try to convince Smith to come in for more in-person appointments because a surgery last year puts her at higher risk of premature labor. She’s more worried about COVID-19, though, and is scheduled for a June 20 cesarean section.
A new study of pregnant patients with COVID-19, the disease caused by the new coronavirus, gave expectant mothers a potential new reason to worry. It found higher rates of injury and blood clots in the placenta due to inadequate blood flow from the mother. The placenta is an organ that forms to provide oxygen and nutrients to the fetus and removes waste products from the baby’s blood.
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But the Northwestern University Medicine researchers who conducted the study said their research on 16 patients isn’t conclusive enough to suggest pregnant women should take greater social distancing and hygiene precautions.
“I started getting panicky emails,” said co-author and pathologist Dr. Jeffery Adam Goldstein, “but people should be cautious, rather than afraid.”
The study in the Journal of Clinical Pathology involved pregnant women with COVID-19 who delivered from March 18 to May 5. It found the women’s third trimester placentas were significantly more likely to show problems getting blood from the mother.
One patient had a stillbirth in the second trimester and another had a preterm delivery. But Goldstein said he couldn’t determine if the virus was the cause.
The 15 surviving babies, however, scored well on an overall well-being test immediately after birth. Fourteen went home within four days of delivery; the 15th was still hospitalized after being born prematurely to a mother whose COVID-19 was worsening and had pneumonia.
Placental injury raises concern because it can lead to the serious, potentially fatal complication pre-eclampsia, as well as miscarriage, preterm birth and low birth weight, said Dr. Rahul Gupta, chief medical and health officer at the March of Dimes.
Still, it is different than actual transmission of the virus to the baby, which may be riskier but remains unproven, Gupta said.
A March study by Chinese researchers concluded that mothers could pass the new coronavirus to fetuses in the womb, but it was discredited in the British medical journal The Lancet and the Journal of the American Medical Association.
Dr. Justin Brandt, a Rutgers University hospital OB/GYN, said there’s no “compelling evidence” the virus is being transmitted from moms to babies.
“While this is reassuring on maternal and fetal fronts, it is worth emphasizing that we continue to learn more about SARS-COV-2 and COVID-19 every day and there is much that we still do not know,” said Brandt, an assistant professor in maternal-fetal medicine at Rutgers Robert Wood Johnson Medical School.
The new study does suggest placental injury could exacerbate the higher maternal and infant health risks faced by minorities and lower income populations.
The Northwestern Medicine physicians and other childbirth experts say their recommendations remain the same even as states begin to relax restrictions. Pregnant women should stay vigilant about social distancing and hand washing, experts said.
Most pregnant woman infected with the virus will have mild to moderate symptoms, said Brandt. While he has seen severe symptoms in pregnant patients, most had medical problems such as asthma or diabetes, he said.