Pregnant? Here’s What to Know About COVID-19 Risk

The COVID-19 pandemic has everyone on edge (and then some). If you’re pregnant, you no doubt have questions about whether the coronavirus poses a risk to you and your developing baby.

The answer to that is complicated and still being discovered as medical experts learn more about how the disease affects women and developing babies during pregnancy.

“COVID-19 is an evolving pandemic, and we’re still learning about its effect on pregnant women and infants,” says Ob/Gyn Oluwatosin Goje, MD. But recent studies show that pregnant women who get symptomatic COVID-19 are at increased risk for getting very sick with the disease.

It’s important to know, though, that your overall risk of complications from COVID-19 is low – and that you can take precautions to reduce your risk of being exposed to the virus.

What we know so far

The culprit behind COVID-19 is a virus named SARS-CoV-2. This new virus is closely related to the SARS-CoV-1 virus (which caused the severe acute respiratory syndrome outbreak in 2002). It’s also a cousin of MERS-CoV (which causes Middle East respiratory syndrome). There’s no evidence that either of those diseases can be passed from mother to fetus during the pregnancy, Dr. Goje notes.

Several studies published since the start of the pandemic have helped shed some light on COVID-19’s impacts on pregnant women. The most recent, a report published by the Centers for Disease Control and Prevention, looked at more than 30,000 pregnant women in the U.S. who had confirmed cases of COVID-19.

The analysis found that women who had COVID-19 and were pregnant were more likely than those who weren’t pregnant to be admitted to an intensive care unit and placed on a ventilator. The risk was highest for pregnant women over age 35.

“Pregnant women have increased risk of complications in part due to changes in their respiratory and immune systems during pregnancy,” Dr. Goje says.

While that can seem scary to hear, know that the risk of those complications is still quite low. In the study, 1% of pregnant women with symptomatic COVID-19 were admitted to the ICU, and less than 0.2% of women died.

Most people – including pregnant women – who get COVID-19 experience mild or no symptoms. In a separate study of 594 pregnant women with COVID-19, it took an average of 37 days for their symptoms to go away. One in four pregnant women had symptoms that lasted eight weeks or longer.

COVID-19 in different trimesters

Doctors still aren’t sure how the disease might affect women and developing babies earlier in pregnancy, during the first trimester.

High fevers in early pregnancy can increase the risk of some birth defects, Dr. Goje notes. That’s something doctors and researchers will need to watch closely as COVID-19 unfolds. “Little is known right now about the impact of COVID-19 in the first trimester,” she says.

In studies, pregnant women with COVID-19 seem most likely to be hospitalized during their third trimester.

A recent report published by the CDC analyzed data about 3,912 infants born to women infected with the coronavirus. The report showed that preterm birth rates among pregnant women with symptomatic COVID-19 were higher than the national average (about 12.9% versus 10.2%). Some newborns also tested positive for COVID-19 in the first week of life, although most did not show any symptoms.

“More information is needed as COVID-19 is an evolving pandemic,” Dr. Goje says. “It is very important that pregnant women do not develop fatigue or apathy about protecting themselves from COVID-19.”

Precautions for pregnant women

While there’s still a lot we don’t know about this disease, we do know actions we can take to avoid it. Dr. Goje recommends these precautions for pregnant women:

• Wash your hands frequently. You’ve heard this advice over and over (and over). But for good reason: Hand hygiene really can stop the virus in its tracks.
• Practice social distancing. Avoid contact with others, especially in large groups. When you’re around other people, try to keep 6 feet between you.
• Get the flu shot. It won’t protect you against COVID-19. But it will lower the risk of catching influenza, another more common respiratory illness that can cause complications for expectant moms.
• Go virtual. Whenever possible, consider virtual prenatal visits with your doctor instead of in-person appointments. Spending less time in the waiting room and doctor’s office might reduce the risk of catching the virus. However, some visits will still need to be in-person, such as ultrasounds, fetal testing and some blood work.
• Call your doctor if you develop symptoms. Cough, sore throat, body aches and fever are the most commonly reported early COVID-19 symptoms in pregnant women. Let your doctor know if you develop any of them, and he or she will determine if you should be tested for the coronavirus and what your next steps should be.

Managing stress and symptoms during pregnancy

It’s an uncertain time, and it’s normal to feel stressed. But there are steps you can take to help keep your stress and anxiety under control. Now’s a good time to lean on your tribe for support. (Just do the leaning mostly via text and phone, social-distancing style.) Consider acquiring a new skill or hobby at home.

Remember, too, that medical teams have been preparing. They have lots of experience treating pregnant women who have the flu and other respiratory viruses, including SARS-CoV-1 and MERS-CoV, Dr. Goje points out. And hospitals have systems for dealing with respiratory disease.

“Knowledge gained from past epidemics helps us understand and manage viral infections in pregnancy,” Dr. Goje says. “We have plans in place for managing pregnant women with symptoms of COVID-19 and to reduce exposure of newborns to the disease.”