This is called vertical transmission, and doctors and scientists don’t yet know definitively if it can occur, let alone how often it occurs, Aagaard said. In general, transmission from a mom to a baby while it is still in the womb is very unusual for common respiratory viral illnesses in pregnancy, such as influenza. Regardless, newborn babies of moms who are known or suspected of being infected with the novel coronavirus are treated by the newborn’s doctors and providers as if they might be infected as well.
It is unlikely, Aagaard said, but currently, there is inadequate and simply not yet reported data on COVID-19 and the risk of miscarriage or congenital anomalies. Data from the SARS epidemic in 2003 and the MERS epidemic in 2012-2013 are reassuring, suggesting that there was no increased risk of fetal loss or congenital anomalies associated with infection early in pregnancy.
Given the limited data available regarding COVID-19 during pregnancy that exists today, doctors and researchers turn to other respiratory viral infections to provide information. For example, other respiratory viral infections during pregnancy, such as influenza, have been associated with adverse neonatal outcomes, including low birth weight and preterm birth, generally thought to be partially due to severe maternal illness. Infants have been born preterm and/or small for gestational age to women with other coronavirus or severe lower respiratory infections, including H1N1, SARS-CoV and MERS-CoV, during pregnancy.
Those who are breastfeeding and have been confirmed to have COVID-19 or who are under investigation, should follow CDC guidance.
Right now, the CDC says there is no known increased risk among pregnant women if compared to similarly healthy women who are not pregnant (see more). But Aagaard said great caution is being taken with pregnant women for two reasons.
First, not all pregnant women start off pregnancy or end pregnancy completely healthy, she said. Second, there is concern that the data pertaining to risks of severe respiratory illness with COVID-19 disease may not be reported yet. “It would be surprising if a virus that causes severe lower respiratory infection does not disproportionately affect pregnant women,” she said.
“If you are pregnant and experience symptoms of shortness of breath, high fever or worsening cough, you should seek medical attention,” Aagaard said. “There are doctors, such as myself and others, who specialize in the care of at-risk pregnant women and are prepared to care for both mother and unborn child.”
“There is a lot we don’t yet know about this disease in pregnancy. Rest assured that we are working day and night to bring to our patients, friends, neighbor, and the community the best and most updated information during this pandemic and public health crisis,” Aagaard said.