• Research is limited but experts don’t see evidence that the disease can be passed in utero.
• Newborns may face risks if they contract the disease after being born.
• Experts are still learning the best way for women who contract COVID-19 to give birth to minimize the risk of transmission.

One of the biggest concerns about COVID-19, the illness caused by the new 2019 coronavirus, is how the infection affects pregnant women and their unborn children.

Though evidence is extremely limited, early research suggests the virus cannot be transmitted in the womb.

Still, after reports circulated this weekend that a newborn baby in Britain tested positive for COVID-19 moments after being born, it’s clear we need more data about the disease before any conclusions can be made.

Here, we take a look at what we do know and address some of the biggest questions people have about COVID-19 and pregnancy.

Can it be passed to my fetus in the womb?

One of the biggest findings in preliminary research is that the virus doesn’t appear to pass from mother to fetus in the womb.

Dr. Wei Zhang, an associate professor of preventive medicine at Northwestern University’s Feinberg School of Medicine, recently co-authored a study that looked at 9 pregnant women in China diagnosed with COVID-19 who gave birth via C-section.

His research team tested amniotic fluid, cord blood, baby’s throat swab, and breast milk, and didn’t find any evidence that the virus could pass from mom to baby in the womb or through a C-section, Zhang said.

The newborn who recently tested positive in England doesn’t disprove these findings — there’s no information about what kind of preventive measures were taken during delivery or what specimens were tested by the family’s medical teams. It’s unclear how the baby contracted the virus.

Though the virus doesn’t seem to be vertically transmitted, an analysis on 10 newborn babies from mothers with COVID-19 found that the infection does seem to have an adverse effect on newborns — including respiratory distress, thrombocytopenia (a low blood platelet count), and abnormal liver function.

Because of this, health experts agree we need more data to fully assess newborns’ risk of contracting the virus.

Which is safer: C-section or vaginal birth?

It’s too soon to say.

All of the women included in Zhang’s research gave birth via C-section, and the risk linked to vaginal births was not assessed.

Certain viral infections can be passed from mom to baby during delivery, according to Dr. Jessica Madden, a board certified pediatrician, neonatologist, and medical director of Aeroflow Breastpumps.

The flu virus, for example, doesn’t pass to babies during vaginal delivery. Other viruses, like HIV and herpes, can spread through blood and bodily fluids, which makes C-sections a safer choice.

There’s no proof either birth method is safer at this time with COVID-19.

“Currently, one mode of delivery [is] not recommended over another,” Madden said. “I’m under the impression it’s the decision of the OB-GYN and it’s going to be case by case.”

One concern about C-sections is that they require patients to spend more time in the hospital recovering.

“If you increase your hospital stay, you’re probably going to increase your risk of getting coronavirus in the hospital since everyone’s who is admitted will be acutely ill,” said Dr. Brian Levine, a board certified reproductive endocrinologist, OB-GYN, and practice director of CCRM Fertility New York.

Does COVID-19 up my risk of complications?

Again, data is limited, but one trend observed across pregnant women with COVID-19 is preterm delivery.

In a recent webinar geared toward health professionals, the Centers for Disease Control and Prevention (CDC) shared their findings from evaluating the health data of 34 women from China diagnosed with COVID-19 in the third trimester.

They reported that pregnant women with COVID-19 have a greater risk of delivering prematurely, and on average, give birth around 36 weeks — 4 weeks before the due date.

In more severe cases, COVID-19 may cause pneumonia, which is a concern for pregnant women because already “their lung capacity is already slightly diminished,” said Madden.

If a pregnant woman experiences severely poor oxygenation, the child may be deprived of oxygen which can put them at a higher risk for lasting developmental issues, according to Levine.

Another concern is that COVID-19 often causes a fever.

In the first trimester, elevated body temperature is associated with fetal developmental anomaly.

In the third trimester, a high body temperature can lead to dehydration which can trigger a premature delivery, Levine added.

Is my immune system up for the task?

A pregnant person’s immune system changes after conception so the body won’t reject the fetus.

Because of this shift, pregnant women’s immunity is slightly diminished — that, in general, puts pregnant women at a higher risk for viral infections, according to Madden.

The flu and other respiratory infections are known to cause more severe illnesses in pregnant women, so the novel coronavirus may do the same — but again, we don’t have enough data to know for sure.

That said, the CDC reported that pregnant women aren’t appearing to become any sicker from COVID-19 than non-pregnant women of the same age.

What happens after I give birth?

Anyone diagnosed with COVID-19, including the mother, will need to be isolated from the newborn until they recover in order to avoid transmitting the virus to the baby, according to Zhang.

The CDC is still advising new moms with COVID-19 to continue to provide breast milk.

Although breast milk doesn’t seem to carry the virus, close contact should be avoided.

“Since direct contact is a confirmed route of transmission, some care needs to be taken to limit the chance of infecting a newborn if they do breastfeed,” Zhang said.

New mothers may need to consider using protective equipment — like masks, gowns, or gloves — or feeding the newborn breast milk via bottle.

What steps should I be taking now?

Pregnant women should maintain a good line of communication with their OB-GYN, and ask if any appointments can be spaced out or conducted remotely to lower the risk of exposure to SARS-CoV-2, the virus.

If a pregnant woman has a known exposure to someone who’s sick or is experiencing any symptoms, it’s crucial to call their OB-GYN as soon as possible, Madden said.

Hand washing, social distancing, and steering clear of anyone who’s sick can lower the risk of being exposed to the virus.

Madden also recommends that pregnant women diagnosed with COVID-19 avoid at-home births.

A hospital can ensure both the mother and the baby are monitored to ensure the baby isn’t developing symptoms or getting sick.

“I don’t think that can be done in a home setting properly,” Madden said. “In this case, for the well-being of both her and her baby, it’s really essential [to give birth at a hospital].”

Other than that, follow the advice from the CDC. As we learn more, the recommendations will change.

At this point, the data we do have is rather reassuring, said Madden. The virus doesn’t seem to spread through the womb.

All newborns, with the exception of the baby in England, have tested negative for COVID-19.

And though pregnant women are considered an at-risk group, Madden said at this point it doesn’t look like they have an increased risk of complications if they develop COVID-19.

The bottom line

Though research on how COVID-19 impacts pregnancy is limited, health experts say the data we do have is reassuring.

The virus doesn’t seem to spread through the womb.

All newborns, with the exception of a newborn in England, have tested negative for COVID-19.

Pregnant women don’t appear to be any sicker than non-pregnant women of the same age. Still, it’s crucial to follow updates from the CDC — this is a rapidly evolving situation and new information is being shared every day.

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