Pregnant women do not appear to be more susceptible to the consequences of coronavirus than the general population and there is no evidence it can be passed from mum to baby during pregnancy, according to new guidance issued by the UK Royal College of Obstetricians and Gynaecologists (RCOG).
In addition, there is no current evidence to suggest an increased risk of miscarriage. And while some babies born to women with symptoms of coronavirus in China have been born prematurely, it's unclear whether this was due to coronavirus or a decision made by doctors to deliver early due to the illness.
The RCOG guidance is based on early studies including a WHO report using data from 147 pregnant women, which included 64 confirmed cases of coronavirus, 82 suspected cases and one asymptomatic case. Of women, eight per cent had severe symptoms while just one per cent were critically ill.
"This guidance has been written to ensure maternity units across the country are providing consistent and safe care to pregnant women with suspected or confirmed coronavirus infection, and that every effort is taken to minimise the potential spread of the infection to medical staff or other patients," said Dr Edward Morris, President of the RCOG on Tuesday.
Professor Russell Viner, President of The Royal College of Paediatrics and Child Health said there was also no evidence to suggest that babies born to mothers who test positive for coronavirus should be separated. "The impact of this separation, even as a precaution, can be significant on both the baby and the mother," he said, adding that they would be reviewing this recommendation over the coming weeks and months as more evidence comes to light.
Dr Viner also noted that there is limited evidence about the transmission of coronavirus through breast milk. "Based on what we know now, we feel the benefits of breastfeeding outweigh any potential risks."
According to RCOG, it is expected that the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms. "More severe symptoms such as pneumonia appear to be more common in older people, those with weakened immune systems or long-term conditions," they note, adding that there are no reported deaths of pregnant women from coronavirus. That said, they do highlight that pregnant women are more vulnerable to getting infections than a woman who is not pregnant. "If you have an underlying heart or lung condition, such as asthma, you may be more unwell if you have coronavirus," the guidelines continue.
Current advice from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is more conservative, noting that while detailed information on the impact of COVID-19 infection on pregnant women and their babies is limited, guidance is based around knowledge from influenza infection and the medical response to the SARS epidemic of 2003.
"Influenza is a potentially serious disease for pregnant women, the fetus and newborn babies," RANZCOG note, explaining that a number of changes occur to a woman's body during pregnancy. "These changes include reduced lung function, increased cardiac output, increased oxygen consumption, and changes to the immune system." As such pregnant women have an increased risk of severe complications from influenza and are more than twice as likely to be admitted to hospital with influenza than the general population."
RANZCOG also highlights the recent Lancet study of 19 pregnant women infected with COVID-19, which found no evidence of mum-to-baby transmission, calling the finding "reassuring" despite the small number of women studied.
The college advises the following preventative measures for pregnant women:
- Hand washing regularly and frequently with an alcohol based hand rub or soap and water
- Avoidance of anyone who is coughing and sneezing
- Avoid touching eyes, nose and mouth
- Early reporting and investigation of symptoms and prompt access to appropriate treatment and supportive measures if infection is significant.
Pregnant women are also advised to avoid all non-essential overseas travel and to report early symptoms to their midwife, obstetrician or GP.
It comes as the number of confirmed cases in Australia reached 100 and multiple schools face temporary closures.