What pregnant women need to know about coronavirus

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Pregnant women are often particularly susceptible to respiratory infections, and once infected can become seriously ill and have long-lasting consequences for both mothers and babies.

Does that apply to the new coronavirus?

The information available so far is thin, but it appears that pregnant women are less likely than anyone to have more severe symptoms of coronavirus. so Analysis of 147 womenAccording to a report released by the World Health Organization on February 28, only 8% of severe illnesses were 1% severe.

It is too early to know the impact of these women on babies. However, a study of at least nine pregnant women and their babies, published in February at The Lancet, shows that at least so far, babies born to women with an infectious disease have not been infected with the virus. At birth, looked healthy.

“Fortunately, there was no evidence of vertical transmission from mother to child,” said Dr. Wei Zhang, an epidemiologist at Northwestern University and one of the authors of the lancet study.

A study presented at JAMA in March provided more relief: Of the 33 newborns born at Wuhan Children’s Hospital, only three had signs of the virus and had mild symptoms. Reported.

Researchers are uncertain of the source of the infection in the three newborns and recommended careful monitoring of pregnant women.

Both studies are small. There is no clue as to the effects of the infection on women during early pregnancy.

Early pregnancy fever has been linked to birth defects and some developmental states. Also, some viruses can have catastrophic consequences for the fetus. ZikaFor example, Unusually small head,and Ebola can be fatal.

In the 1918 and 1957 flu pandemics, maternal mortality was 30-50%. The tendency of pregnant women to become infected with SARS, the closest relative to the new coronavirus, is no longer encouraging. In one small study of 12 Hong Kong pregnant women who developed SARS during the 2003 outbreak, 3 people diedAnd, of the seven women in the first semester, four had spontaneous abortions.

While both WHO statistics and Dr. Zhang’s work on the new coronavirus are optimistic, experts say more data is important.

“We know that a large number of pregnant women with coronavirus will emerge, given the number of cases,” said Dr. Dennis Jamison, director of obstetrics and gynecology at Emory University. “It’s important that surveillance systems gather information about pregnancy status.”

Dr. Jamison is one of three experts who created the American College of Obstetrics and Gynecology. Guidelines To treat pregnant women infected with coronavirus. Among other best practices, the guidelines include screening physicians for pregnant women even before appointments, ensuring that symptomatic women can wait elsewhere from other patients, and obtaining detailed travel history. I am looking for

On their side, pregnant women Same precautionary measures as everyone else But if so, let your doctor know immediately I have symptomsSaid Dr. Jamison.

Pregnant women can also obtain a copy of their health record in advance. This will “keep a record of prenatal care in the event of service interruption,” she said.

Dr. Jamison was at the Center for Disease Control and Prevention during the 2009 H1N1 pandemic. About one in three pregnant women infected with the virus Hospitalized.

C.D.C. then recommended leaving the infant until the pregnant woman giving birth was free of infection. According to Dr. Jamieson, women continued to milk breast milk, but were encouraged to discard it until the disease was gone.

He said similar measures may be needed for coronaviruses. “Separating mom and baby is clearly a difficult problem.”

The infected mother in Dr. Zhang’s lancet study was isolated from the infant. All nine women gave birth at a cesarean section, minimizing exposure of the newborn to the virus. Dr. Zhang’s collaborators in the epicenter of the epidemic examined cord blood, infant pharyngeal swabs, breast milk, and amniotic fluid.

“No evidence of the virus was found,” said Dr. Zhang.

In other reports of infected babies, Study of 10 newborns Dr. Zhang said that infants with serious complications could have been tested a few hours after birth or had direct contact with the infected mother because the woman had not been diagnosed before childbirth.

“With proper isolation and strict protocols, healthy babies should be more likely to be born,” he said.

Dr. Zhang cautioned to emphasize that his research provided “good news” only to women in late pregnancy. “We should be very careful not to misunderstand other groups of pregnant women,” he said. “We do not know the actual effect of the virus on women in early pregnancy.”

If a woman in early pregnancy turns out to be at risk, she becomes a major candidate for vaccine. The first trial of the vaccine will begin later this month, Criteria exclude pregnant women.

Dr. Ruth Karon, a vaccinologist and collaborator at Johns Hopkins University, said their exclusion was appropriate for this stage of vaccine development. Preventive guidance For including pregnant women in clinical trials.

To provide vaccines to pregnant women, scientists must first balance risks and benefits. In this case, she said that she was both unknown. Researchers need to know the nature and prevalence of the disease in pregnant women, and the potentially dangerous side effects of vaccines, such as fever.

However, as researchers learn more, researchers should plan to include pregnant women in subsequent trial iterations, Dr. Karon said: “This is the first trial, that’s it-the first It’s an exam. “

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