What to Know About Pregnancy and COVID-19


Researchers are still learning how COVID-19—the disease caused by the SARS-CoV-2 infection—affects pregnant people. Current reports suggest that pregnant people have a higher risk for more severe illness from COVID-19 than nonpregnant people. Pregnancy can make you more susceptible to certain infections and may also make these infections more severe.

Some underlying medical conditions, and other factors—such as age or occupation—can further increase a pregnant person’s risk for developing severe illness from COVID-19.

Pregnant people with COVID-19 might also be at increased risk for other poor outcomes, such as preterm birth (delivering the baby earlier than 37 weeks).

Read on to learn about how COVID-19 might affect pregnant people, including risk factors, symptoms to look out for, when to see your doctor, and more.

LeoPatrizi / Getty Images


Pregnancy and COVID-19 Risk

When talking about pregnancy and COVID-19 risk, it’s important to separate the question into two topics:

  • Susceptibility: Is someone who is pregnant more likely to contract COVID-19 when exposed to the virus?
  • Outcomes: Is someone who is pregnant and develops COVID-19 more likely to have bad outcomes, such as hospitalization, intensive care admission, the need to be intubated, or death?

Susceptibility

Whether being pregnant increases the risk of becoming infected with COVID-19 when exposed is still unclear, but we do know that due to changes in your body and immune system, pregnant people can be badly affected by some respiratory infections. Given the growing evidence, the Centers for Disease Control and Prevention (CDC) now includes pregnant people in its “increased risk” category for COVID-19 illness. 

The H1N1 influenza A pandemic of 2009 was a reminder that certain infections may disproportionately affect pregnant people, with those who were pregnant having an increased risk for severe disease. In the United States, 5% of all deaths from pandemic influenza were among pregnant people, although pregnant people represent only about 1% of the U.S. population.

Many studies have been carried out to identify those more susceptible to COVID-19. A systematic review and meta-analysis of 192 studies, published in the British Medical Journal, found that the following risk factors were associated with severe COVID-19 in pregnancy:

Conditions in the places where pregnant people live, learn, and work may also affect health risks and outcomes. For example, people who are pregnant and work in places where they cannot distance themselves from people who may be sick—like healthcare providers—are at increased risk for getting sick and developing severe illness from COVID-19.

COVID-19 and Frontline Workers

Research published in The Lancet noted that between March 24 and April 23, 2020, frontline healthcare workers had at least a threefold increased risk of reporting a positive COVID-19 test and predicted COVID-19 infection, compared with the general community.

Post-hoc analyses showed that Black, Asian, and minority ethnic healthcare workers are at especially high risk of COVID-19 infection, with at least a fivefold increased risk of COVID-19 compared with the non-Hispanic White general community.

Outcomes

In a report from the CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team that included over 23,000 pregnant persons and over 386,000 nonpregnant females of reproductive age with confirmed COVID-19 infection, pregnant patients had a higher risk of:

  • ICU admission (10.5 vs. 3.9 per 1,000 cases)
  • Receiving invasive ventilation (2.9 vs. 1.1 per 1,000 cases)
  • Receiving extracorporeal membrane oxygenation (ECMO) (0.7 vs. 0.3 per 1,000 cases)
  • Death (1.5 vs. 1.2 per 1,000 cases)

The risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Pregnant people with COVID-19 might also be at increased risk for other poor outcomes related to pregnancy, such as preterm birth (delivering the baby earlier than 37 weeks).

Complications of Pregnancy and COVID-19

During pregnancy, your body goes through a number of physiological changes which have a significant impact on the immune system, respiratory system, and cardiovascular function. In general, pregnant people are more susceptible to illness than nonpregnant people, as pregnancy decreases your immune system response.

It’s worth noting that some of the clinical manifestations of COVID-19 overlap with symptoms of normal pregnancy such as:

  • Fatigue
  • Shortness of breath
  • Nasal congestion
  • Nausea and/or vomiting

The recent meta-analysis published in the British Medical Journal found that 40% of pregnant people with COVID-19 experienced common symptoms such as fever and cough. Other COVID-19 symptoms, like respiratory issues and the development of pneumonia, seemed more likely to occur in those who are pregnant, according to the review.

This could, in part, help explain why an increased number of pregnant people need ICU support either during or immediately after pregnancy.

Pregnant people with COVID-19 were also found to be more likely to give birth prematurely. The findings also show that one in four of all babies born to people with COVID-19, were admitted to a neonatal unit, but data on causes of preterm births or reasons for admission to neonatal units among these babies are lacking. Stillbirth and newborn death rates, however, were low.

At present, the extent to which mother-to-child transmission of COVID-19 occurs, either in utero, during birth, or in the early postnatal period, is unclear.

Long-Haul Symptoms and Pregnancy

Long-haulers are still being studied.

In the largest study to date of COVID-19 among nonhospitalized pregnant people, researchers analyzed the clinical course and outcomes of 594 pregnant people who tested positive for the virus during pregnancy. They found that half of the participants still had symptoms after three weeks and 25% had symptoms after eight weeks.

Pregnancy Treatments and COVID-19

If you’re pregnant, you may wonder whether your medications could affect your risk of COVID-19. And if you should develop COVID-19, would your treatment differ from someone who is not pregnant?

Pregnancy Treatments During the COVID-19 Pandemic

It is important to continue getting the health care you need to stay healthy, even while COVID-19 is spreading. Most pregnant people who are due for screenings, tests, or other care from any healthcare professionals can go ahead with these appointments, with appropriate safety measures in place at the healthcare office.

Two vaccines are recommended for pregnant people during each and every pregnancy: the flu shot and Tdap. Maternal immunizations continue to be an essential component of prenatal care during the COVID-19 pandemic.

Currently, there is no evidence to suggest that taking any specific medications, like blood pressure medication, leads to more severe illness from COVID-19.

Continue to take your medications and follow your treatment plan as prescribed by your healthcare provider.

COVID-19 Treatments During Pregnancy

To date, most of the data generated about the epidemiology, clinical course, prevention, and treatment of COVID-19 have come from studies of nonpregnant adults. More information is urgently needed regarding COVID-19 in other patient populations, such as pregnant individuals.

The National Institutes of Health guidance indicates:

  • Pregnant people should be counseled about the potential for severe disease from SARS-CoV-2 infection and the recommended measures to take to protect themselves and their families from infection.
  • If hospitalization for COVID-19 is indicated in a pregnant person, care should be provided in a facility that can conduct maternal and fetal monitoring, when appropriate.
  • Potentially effective treatment for COVID-19 should not be withheld from…



Read More:What to Know About Pregnancy and COVID-19

What to Know About Pregnancy and COVID-19


Researchers are still learning how COVID-19—the disease caused by the SARS-CoV-2 infection—affects pregnant people. Current reports suggest that pregnant people have a higher risk for more severe illness from COVID-19 than nonpregnant people. Pregnancy can make you more susceptible to certain infections and may also make these infections more severe.

Some underlying medical conditions, and other factors—such as age or occupation—can further increase a pregnant person’s risk for developing severe illness from COVID-19.

Pregnant people with COVID-19 might also be at increased risk for other poor outcomes, such as preterm birth (delivering the baby earlier than 37 weeks).

Read on to learn about how COVID-19 might affect pregnant people, including risk factors, symptoms to look out for, when to see your doctor, and more.

LeoPatrizi / Getty Images


Pregnancy and COVID-19 Risk

When talking about pregnancy and COVID-19 risk, it’s important to separate the question into two topics:

  • Susceptibility: Is someone who is pregnant more likely to contract COVID-19 when exposed to the virus?
  • Outcomes: Is someone who is pregnant and develops COVID-19 more likely to have bad outcomes, such as hospitalization, intensive care admission, the need to be intubated, or death?

Susceptibility

Whether being pregnant increases the risk of becoming infected with COVID-19 when exposed is still unclear, but we do know that due to changes in your body and immune system, pregnant people can be badly affected by some respiratory infections. Given the growing evidence, the Centers for Disease Control and Prevention (CDC) now includes pregnant people in its “increased risk” category for COVID-19 illness. 

The H1N1 influenza A pandemic of 2009 was a reminder that certain infections may disproportionately affect pregnant people, with those who were pregnant having an increased risk for severe disease. In the United States, 5% of all deaths from pandemic influenza were among pregnant people, although pregnant people represent only about 1% of the U.S. population.

Many studies have been carried out to identify those more susceptible to COVID-19. A systematic review and meta-analysis of 192 studies, published in the British Medical Journal, found that the following risk factors were associated with severe COVID-19 in pregnancy:

Conditions in the places where pregnant people live, learn, and work may also affect health risks and outcomes. For example, people who are pregnant and work in places where they cannot distance themselves from people who may be sick—like healthcare providers—are at increased risk for getting sick and developing severe illness from COVID-19.

COVID-19 and Frontline Workers

Research published in The Lancet noted that between March 24 and April 23, 2020, frontline healthcare workers had at least a threefold increased risk of reporting a positive COVID-19 test and predicted COVID-19 infection, compared with the general community.

Post-hoc analyses showed that Black, Asian, and minority ethnic healthcare workers are at especially high risk of COVID-19 infection, with at least a fivefold increased risk of COVID-19 compared with the non-Hispanic White general community.

Outcomes

In a report from the CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team that included over 23,000 pregnant persons and over 386,000 nonpregnant females of reproductive age with confirmed COVID-19 infection, pregnant patients had a higher risk of:

  • ICU admission (10.5 vs. 3.9 per 1,000 cases)
  • Receiving invasive ventilation (2.9 vs. 1.1 per 1,000 cases)
  • Receiving extracorporeal membrane oxygenation (ECMO) (0.7 vs. 0.3 per 1,000 cases)
  • Death (1.5 vs. 1.2 per 1,000 cases)

The risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Pregnant people with COVID-19 might also be at increased risk for other poor outcomes related to pregnancy, such as preterm birth (delivering the baby earlier than 37 weeks).

Complications of Pregnancy and COVID-19

During pregnancy, your body goes through a number of physiological changes which have a significant impact on the immune system, respiratory system, and cardiovascular function. In general, pregnant people are more susceptible to illness than nonpregnant people, as pregnancy decreases your immune system response.

It’s worth noting that some of the clinical manifestations of COVID-19 overlap with symptoms of normal pregnancy such as:

  • Fatigue
  • Shortness of breath
  • Nasal congestion
  • Nausea and/or vomiting

The recent meta-analysis published in the British Medical Journal found that 40% of pregnant people with COVID-19 experienced common symptoms such as fever and cough. Other COVID-19 symptoms, like respiratory issues and the development of pneumonia, seemed more likely to occur in those who are pregnant, according to the review.

This could, in part, help explain why an increased number of pregnant people need ICU support either during or immediately after pregnancy.

Pregnant people with COVID-19 were also found to be more likely to give birth prematurely. The findings also show that one in four of all babies born to people with COVID-19, were admitted to a neonatal unit, but data on causes of preterm births or reasons for admission to neonatal units among these babies are lacking. Stillbirth and newborn death rates, however, were low.

At present, the extent to which mother-to-child transmission of COVID-19 occurs, either in utero, during birth, or in the early postnatal period, is unclear.

Long-Haul Symptoms and Pregnancy

Long-haulers are still being studied.

In the largest study to date of COVID-19 among nonhospitalized pregnant people, researchers analyzed the clinical course and outcomes of 594 pregnant people who tested positive for the virus during pregnancy. They found that half of the participants still had symptoms after three weeks and 25% had symptoms after eight weeks.

Pregnancy Treatments and COVID-19

If you’re pregnant, you may wonder whether your medications could affect your risk of COVID-19. And if you should develop COVID-19, would your treatment differ from someone who is not pregnant?

Pregnancy Treatments During the COVID-19 Pandemic

It is important to continue getting the health care you need to stay healthy, even while COVID-19 is spreading. Most pregnant people who are due for screenings, tests, or other care from any healthcare professionals can go ahead with these appointments, with appropriate safety measures in place at the healthcare office.

Two vaccines are recommended for pregnant people during each and every pregnancy: the flu shot and Tdap. Maternal immunizations continue to be an essential component of prenatal care during the COVID-19 pandemic.

Currently, there is no evidence to suggest that taking any specific medications, like blood pressure medication, leads to more severe illness from COVID-19.

Continue to take your medications and follow your treatment plan as prescribed by your healthcare provider.

COVID-19 Treatments During Pregnancy

To date, most of the data generated about the epidemiology, clinical course, prevention, and treatment of COVID-19 have come from studies of nonpregnant adults. More information is urgently needed regarding COVID-19 in other patient populations, such as pregnant individuals.

The National Institutes of Health guidance indicates:

  • Pregnant people should be counseled about the potential for severe disease from SARS-CoV-2 infection and the recommended measures to take to protect themselves and their families from infection.
  • If hospitalization for COVID-19 is indicated in a pregnant person, care should be provided in a facility that can conduct maternal and fetal monitoring, when appropriate.
  • Potentially effective treatment for COVID-19 should not be withheld from…



Read More:What to Know About Pregnancy and COVID-19