Pregnant Women: Take These Important Steps to Prevent COVID-19

You’ve probably already heard about risks of COVID-19 for older adults and people with certain high-risk conditions. But, new data is showing that COVID-19 can also be particularly risky for pregnant women and the babies they are carrying. Are you or someone you love pregnant? Read on for more information on risks to pregnant women during this pandemic, and important preventive steps.

The Centers for Disease Control and Prevention (CDC) published two studies in last week’s Morbidity and Mortality Weekly Report (MMWR) about COVID-19 during pregnancy. The first study looked at births and health of newborns born to women who were infected with COVID-19 while they were pregnant. CDC scientists and public health experts examined medical data on over 5000 pregnant women with laboratory-confirmed COVID-19 in thirteen states, two large cities and one U.S. territory.

The CDC found that just over 1 in 8 babies (13%) born to women infected with COVID-19 while pregnant were born premature (before 37 weeks’ gestation). In contrast, only 1 in 10 (10%) babies born in the U.S. in 2019 were premature. Just under 1 in 10 of the babies born to mothers with COVID-19 were admitted to the neonatal intensive care unit (NICU), although the reason for admission was not always documented so we don’t know whether they were admitted due to prematurity, COVID-19, or some other reason. The rates of prematurity and NICU admission were about the same for women with symptoms of COVID-19 compared with those with asymptomatic COVID-19 – that is, women who had laboratory tests positive for COVID-19 but no cough, fever or other symptoms.

The CDC had records of COVID-19 tests on 610 babies born to mothers with COVID-19. A little over 1 in 25 (4.3%) babies whose mothers had documented COVID-19 less than 2 weeks before childbirth tested positive for COVID-19 at birth. In contrast, no (0 out of 84) babies whose mothers had COVID-19 more than 2 weeks before childbirth tested positive. None of the babies were tested for COVID-19 immunity. Therefore, this suggests that a pregnant women who has COVID-19 less than 2 weeks before she gives birth can pass it to her baby, but it’s unclear whether it is passed during pregnancy (e.g., across the placenta) or by close contact after the baby is born.

There are a few notable limitations to this study: first, it is a case series of pregnant women infected with COVID-19 this year that compares results against national rates from last year. While the rate of prematurity appears higher than we might expect, these women weren’t directly compared against pregnant women who did not have COVID-19 at the same time. It’s possible that rates of prematurity may have risen this year for unrelated reasons. Additionally, 85% of women in this study were diagnosed with COVID-19 in their third trimester of pregnancy. Additional studies are needed to identify risks associated with COVID-19 infection in the first or second trimester. However, it raises important questions that should be studied further.

The second study looked at the severity of COVID-19 among pregnant women compared with non-pregnant women of childbearing age who were infected with COVID-19 around the same time. This study looked at over 400,000 U.S. women age 15 to 44 years who were infected with COVID-19 between January and October 2020. The researchers compared pregnant women in this group with women in the same group who were not pregnant, and controlled for age, race and ethnicity, and underlying health conditions. Pregnant women with COVID-19 were three times more likely than non-pregnant women with COVID-19 to be admitted to the ICU, nearly three times more likely to be ventilated, and nearly twice as likely to die.

Together, these studies suggest that pregnant women are at higher risk of severe COVID-19 infection than are non-pregnant women, and that COVID-19 infection during pregnancy may increase risk of prematurity, NICU admission of newborn babies and COVID-19 spread from mother to child.

If you or someone you love is pregnant right now, then it’s more important than ever before to wear a mask, stay home when possible and keep your distance from others when you can’t stay home, wash your hands and clean high-touch surfaces frequently. These steps aren’t only important for pregnant women, but for everyone who spends time around them in order to reduce the risk of spreading COVID-19 to the pregnant women. We don’t yet know whether pregnant women will be able to get a COVID-19 vaccine when it first comes out; if it isn’t then it will be even more important for the people who live and spend time with them to surround them in a protective “cocoon” of vaccinated, mask-wearing, social distancing people.

Additionally, please don’t let fear of infection keep you from prenatal care appointments! Prenatal care is critical to maintain a safe pregnancy and identify warning signs of preterm birth and other issues. Most healthcare providers are taking extra precautions to protect patients against COVID-19 right now. If you’re worried about catching COVID-19 at your prenatal care provider’s office, then please call them to discuss your concerns.

Let me know in the comments if you have any other questions about COVID-19 in pregnancy or any other topics you’d like me to cover.

Stay safe, wear your mask and keep up with your healthcare appointments,

🤰 Dr. B