Are pregnant women more at risk of infection, or at increased risk for severe illness with COVID-19, compared with the general public?
We do not have enough information from published scientific reports about whether pregnant women are at greater risk of COVID-19. However we know that pregnant women are generally considered to be at higher risk of viral respiratory infections due to changes in their immune system during pregnancy, which may put them at increased risk of COVID-19. They may also be at risk for severe illness compared to the general population as observed in cases with other coronavirus infections (like SARS-CoV and MERS-CoV) as well as other viral infections like influenza.
If I am pregnant what can I do to reduce my chances of acquiring infection?
The risk of infection to the general public is low. The most important thing you can do is ensure you use usual preventive actions to avoid infection such as washing your hands often and avoiding people who are sick.
Transmission during pregnancy or delivery
Can pregnant women with COVID-19 pass the virus to their fetus or newborn (i.e. vertical transmission)?
The virus that causes COVID-19 is thought to spread mainly by close contact with an infected person through respiratory droplets. Whether a pregnant woman with COVID-19 can transmit the virus that causes COVID-19 to her fetus or neonate by other routes of vertical transmission (before, during, or after delivery) is still unknown. However, in limited recent case series of infants born to mothers with COVID-19 published in the peer-reviewed literature, none of the infants have tested positive for the virus that causes COVID-19. Additionally, virus was not detected in samples of amniotic fluid or breastmilk.
Limited information is available about vertical transmission for other coronaviruses (MERS-CoV and SARS-CoV) but vertical transmission has not been reported for these infections.
If I have COVID-19 will there be any adverse outcomes on my baby?
Based on limited case reports, adverse infant outcomes (e.g. preterm birth) have been reported among infants born to mothers positive for COVID-19 during pregnancy. However, it is not clear that these outcomes were related to maternal infection, and at this time the risk of adverse infant outcomes is not known. Given the limited data available related to COVID-19 during pregnancy, knowledge of adverse outcomes from other respiratory viral infections may provide some information.
For example, other respiratory viral infections during pregnancy, such as influenza, have been associated with adverse neonatal outcomes, including low birth weight and preterm birth.
Additionally, having a cold or influenza with high fever early in pregnancy may increase the risk of certain birth defects. Infants have been born preterm and/or small for gestational age to mothers with other coronavirus infections, SARS-CoV and MERS-CoV, during pregnancy.
Is there a risk that COVI0-19 in a pregnant woman or neonate could have long-term effects on infant health and development that may require clinical support beyond infancy?
At this time, there is no information on long-term health effects on infants either with COVID-19, or those exposed to the virus that causes COVID-19 in utero. In general, prematurity and low birth weight are associated with adverse long-term health effects.
Transmission through breast milk
Can I breastfeed my baby if I have COVID-19 or I have been tested for COVID-19?
There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and health care practitioners. Currently, the primary concern is not whether the virus can be transmitted through breastmilk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding. A mother with confirmed COVID-19 or who is being tested for COVID-19 should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while breastfeeding. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.
In limited case series reported to date, no evidence of virus has been found in the breast milk of women infected with COVID-19; however, it is not yet known if COVID-19 can be transmitted through breast milk (ie, infectious virus in the breast milk).
- Huijun Chen, Juanjuan Guo, Chen Wang, Fan Luo, Xuechen Yu, Wei Zhang, Jiafu Li, Dongchi Zhao, Dan Xu, Qing Gong, Jing Liao, Huixia Yang, Wei Hou, Yuanzhen Zhang, Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records, The Lancet, Volume 395, Issue 10226, 2020, Pages 809-815
Last Modified: Tuesday, 17 March 2020