Q&A: Covid & pregnancy, and advice on eating for two

Mother-to-baby transmission is uncommon, and most infected babies have mild symptoms or no symptoms at all.

I just found out that I am expecting my second baby. During the first wave it seemed that pregnant women weren’t really affected, but now I’ve heard a number of stories about pregnant women getting really ill with it. Will it affect my baby? If I get it, will they do a caesar to get the baby out? Is it possible that I can get it, but my baby not? What are good sources of information about being pregnant with Covid – I don’t want to read scary stories, just facts.

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Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.

DR KOLL ANSWERS: Before answering your question, I believe that it is important to point out that there is a lot that we still do not understand about Covid-19. What we do believe and the advice that we give may change before the publication of this magazine. Until a few months ago, the advice was

that pregnant women are no more likely to get severe disease than the non-pregnant population. Recent studies, however, indicate that there are some increased risks in pregnancy. It is important to understand that although certain risks are increased in pregnancy, the overall risk of severe disease is still low, and the vast majority of pregnant women who contract Covid will have mild disease. In addition, women who fall pregnant tend to be younger and healthier than the general population. A recent study from the USA involved 400 000 pregnant women, 6 380 of whom were Covid positive at delivery. Those who developed severe disease were more likely to be of Black or Hispanic descent and to be suffering from diabetes and/or obesity.

There was a significantly increased risk of needing mechanical ventilation (but only 1.3 percent of Covid-positive pregnant patients needed ventilation, so the absolute risk is still low.)

There was a small increase in caesareansection rates and an increased incidence of premature labour and foetal loss. Pregnant women were more likely to need admission to intensive care units, and there was an increased risk of blood clots. I must emphasise again that the vast majority of women who get infected with Covid will have mild disease. Mother-tobaby transmission is uncommon, and most infected babies have mild symptoms or no symptoms at all.

The method of delivery does not seem to affect the infection rate in the baby. It is thus most likely that if the mother has Covid in her pregnancy, the baby will not be infected.

There is thus a small increased risk of severe disease in pregnancy, especially if the known high risk co-morbidities like diabetes, obesity and high blood pressure are present as well. Be extra careful about wearing a mask, social distancing, washing hands and disinfecting. Avoid crowds and gatherings.

The Royal College of Obstetricians and Gynaecologists has a patient information section on its website covering a large number of topics. The section on Covid also contains links to other useful sites. Just Google RCOG and search for “Covid in pregnancy”. ●