Managing Coronavirus (COVID-19) in pregnancy and advice on breastfeeding

5 mins
Overview

What is Coronavirus?

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)1.

Novel coronavirus (COVID-19) is a new strain that has not been identified in humans before the current outbreak1.

Healthcare professional with pregnant woman
Common symptoms of COVID-19 include2:
  • Fever
  • A new, continuous cough
  • Shortness of breath

In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, and even death. The risk for these severe symptoms appears to increase with age and or underlying medical conditions.3

What is the effect of Coronavirus in pregnancy?

Guidance on COVID -19 infection and pregnancy1 was published by the Royal College of Obstetricians and Gynaecologists (RCOG) and other UK maternity health bodies*. This guidance states that pregnant women do not appear to be more susceptible to infection of COVID -19 than the general population however, changes to the immune system in pregnancy may be associated with more severe symptoms. This is particularly true towards the end of pregnancy.

As of March 16th, Pregnant women have been placed in a vulnerable group by the Chief Medical Officer. This means that the UK government advises pregnant women to reduce social contact through social distancing measures.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms. Data is limited but special consideration should be given to pregnant women with concomitant medical illnesses who could be infected with COVID -19, until the evidence base provides clearer information. On Friday March 20th, the UK Obstetric Surveillance System launched a registry for women admitted to a UK hospital with confirmed COVID -19 infection in pregnancy. This will help to support future evidence-based updates to government guidance.

What evidence is there for transmission of COVID-19 in pregnancy?

Findings from a small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women with COVID-19 pneumonia in late pregnancy4. In any case, pregnant women should continue to follow appropriate precautions to protect themselves from exposure to the virus and seek medical care early, if experiencing symptoms1.

Breastfeeding and COVID-19

Considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, breastfeeding should be continued1,2. However, precautions should be taken, as there is a risk of transmission from mother to infant through respiratory droplets and direct contact, as well as through contaminated surfaces. Details on precautions can be found in the RCOG Guidelines. Breastfeeding mothers in affected and at-risk areas experiencing symptoms should also seek medical care early.

The RCOG have also published FAQs for pregnant women and their families, which may help you when dealing with further questions from parents:

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

The evidence for COVID-19 is continuously changing, please check the NHS and RCOG page for the most up to date information.

References Show all Hide all
  1. RCOG 2020.Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals. Version 2: Published Monday 13th March, 2020

  2. https://www.nhs.uk/conditions/coronavirus-covid-19/

  3. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

  4. Rasmussen S, Smulian J, Lednicky J, et al. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology 2020 doi: https://doi.org/10.1016/j.ajog.2020.02.017

Healthcare professional with pregnant woman
5 mins

Managing Coronavirus (COVID-19) in pregnancy and advice on breastfeeding

Overview

What is Coronavirus?

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)1.

Novel coronavirus (COVID-19) is a new strain that has not been identified in humans before the current outbreak1.

Common symptoms of COVID-19 include2:
  • Fever
  • A new, continuous cough
  • Shortness of breath

In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, and even death. The risk for these severe symptoms appears to increase with age and or underlying medical conditions.3

What is the effect of Coronavirus in pregnancy?

Guidance on COVID -19 infection and pregnancy1 was published by the Royal College of Obstetricians and Gynaecologists (RCOG) and other UK maternity health bodies*. This guidance states that pregnant women do not appear to be more susceptible to infection of COVID -19 than the general population however, changes to the immune system in pregnancy may be associated with more severe symptoms. This is particularly true towards the end of pregnancy.

As of March 16th, Pregnant women have been placed in a vulnerable group by the Chief Medical Officer. This means that the UK government advises pregnant women to reduce social contact through social distancing measures.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms. Data is limited but special consideration should be given to pregnant women with concomitant medical illnesses who could be infected with COVID -19, until the evidence base provides clearer information. On Friday March 20th, the UK Obstetric Surveillance System launched a registry for women admitted to a UK hospital with confirmed COVID -19 infection in pregnancy. This will help to support future evidence-based updates to government guidance.

What evidence is there for transmission of COVID-19 in pregnancy?

Findings from a small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women with COVID-19 pneumonia in late pregnancy4. In any case, pregnant women should continue to follow appropriate precautions to protect themselves from exposure to the virus and seek medical care early, if experiencing symptoms1.

Breastfeeding and COVID-19

Considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, breastfeeding should be continued1,2. However, precautions should be taken, as there is a risk of transmission from mother to infant through respiratory droplets and direct contact, as well as through contaminated surfaces. Details on precautions can be found in the RCOG Guidelines. Breastfeeding mothers in affected and at-risk areas experiencing symptoms should also seek medical care early.

The RCOG have also published FAQs for pregnant women and their families, which may help you when dealing with further questions from parents:

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

The evidence for COVID-19 is continuously changing, please check the NHS and RCOG page for the most up to date information.

References Show all Hide all
  1. RCOG 2020.Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals. Version 2: Published Monday 13th March, 2020

  2. https://www.nhs.uk/conditions/coronavirus-covid-19/

  3. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

  4. Rasmussen S, Smulian J, Lednicky J, et al. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology 2020 doi: https://doi.org/10.1016/j.ajog.2020.02.017