What we know about how the coronavirus affects pregnant women

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SARS-CoV-2 is not transmitted from pregnant women to their newborn children . There is no scientific evidence at the moment. Neither did the British baby who was born a few days ago and of whom they said he was infected, something that has generated much concern among expectant mothers.

Already at that time The Guardian published that it was not known if the child contracted the disease in the womb or if he became infected during delivery. "If so, any scientist would like to give that first case, but there is nothing, we have been waiting and there is nothing. Not a single scientific publication about it, nor a letter to the editor , nothing," says Juan Luis Delgado, coordinator of the Perinatal Medicine section of the Spanish Society of Gynecology and Obstetrics (SEGO) and head of the Maternal-Fetal Unit of the Virgen de la Arrixaca University Hospital (Murcia).

In fact, on the same Friday, the British Royal College of Obstetricians and Gynecologists published the guide Coronavirus (Covid-19) Infection in pregnancy , for health professionals where it was indicated that there is no evidence of intrauterine fetal infection, so " it considers the virus unlikely to have congenital effects on fetal development . "

Delgado explains that the studies that have been done so far are all based on Chinese cases. "At the beginning there was not much information and we were very cautious with the sources that came from Wuhan because they were not very reliable." Every day the data is updated with new research being carried out.

Intrauterine transmission

The most critical aspects are possible vertical transmission and lactation . Regarding the first point, more studies are needed and with larger samples, but to date all indicate that there is no intrauterine contagion. Thus, Lancet published on February 12 an investigation with nine women and none transmitted Covid-19 to their babies. Amniotic fluid, umbilical cord blood, and neonatal throat swab samples were evaluated. All negative. Breast milk samples were also analyzed and were negative in SARS-CoV-2.

Around the same time, Transnational Pediatrics published another study on nine women, one of whom had given birth to twins. Of the 10 children, six were born prematurely and four at term. One of them died days later. Although all neonatal pharyngeal swabs were negative for SARS-CoV-2, there were several problems including fetal distress, premature delivery, and respiratory distress. But it is not clear that intrauterine fetal distress is directly related to coronavirus infection.

Although it is true that in the case of SARS and MERS, first cousins of Covid-19, there were cases of miscarriage and even fetal death, experts repeat that there is no evidence to date of intrauterine transmission by this new type of coronavirus.

And this is confirmed by another study published yesterday in the journal Frontiers in Pediatrics , based on four full-term newborns of pregnant women who tested positive for Covid-19 in Wuhan. All were isolated in intensive care units, three tested negative and the mother of the fourth did not give permission to test. One of the newborns experienced a minor respiratory problem for three days that was treated with non-invasive mechanical ventilation, and two babies, including the one with respiratory problems, had body rashes that went away on their own, something they cannot directly relate to. the coronavirus.

Breastfeeding

Regarding breastfeeding, Juan Luis Delgado explains that the WHO issued recommendations on this topic last Friday. "The tendency at first for mothers who have tested positive, even if babies test negative for Covid-19, was to avoid all contact, to separate them at least two meters, the safety distance, and to stop breastfeeding. If milk was analyzed and it was negative for the coronavirus, it could be administered but by another person, not the mother, "Delgado says.

"But the WHO now advocates skin-to-skin contact, within the guidelines of humanization of childbirth, with breastfeeding since the benefits outweigh the risks - in the case of babies, the aggressiveness of Covid-19 is very low- , and the protective effect of breastfeeding is especially against infectious diseases with the direct transfer of antibodies, "says the coordinator of the Perinatal Medicine section of SEGO.

Babies born to mothers who have or are suspected of having Covid-19 should therefore be fed according to standard infant feeding guidelines , applying the necessary precautions for infection prevention and control measures. It is recommended that during feeding they use a mask -to prevent any droplets from reaching the baby when breathing or talking-, that they wash their hands properly before and after contact with the baby, and that they routinely clean and disinfect surfaces with which the mother has been in contact.

Guide for Spain

At this time there are not many cases of Covid-19 in pregnant women in Spain, but they are being followed in Madrid and Barcelona. Children are negative for now, says Delgado, reinforcing the idea that there is no intrauterine transmission, "but it would be good to extend the analysis to the placenta and the umbilical cord. It is extremely complicated because the protection measures are so high due to the high infectivity of this virus and the risk for the sanitary insoles that all the material is destroyed, our virologists refuse to have samples and tissues from one place to another. "

Despite this, Delgado adds that they did it with Zika and in this case they will do everything possible to study it further. Remember the specialist that this Monday was the deadline for revision of the guideline for action on pregnant and lactating women with respect to the Covid-19, protocol in which the Federation of Midwifery Associations of Spain and the Spanish Society of Neonatology are working with the Ministry of Health, so the guide could see the light today or in a couple of days.

According to the criteria of The Trust Project

• Science and health
• Coronavirus
• Covid 19
• Infectious diseases
• Respiratory diseases
• Pregnancy

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