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COVID-19 – Possible risks during pregnancy: An interview with Doctor Dietmar Schlembach

Doctor Schlembach, does it make sense to test every pregnant woman for corona?

No, that is not necessary. Screening recommendations vary from country to country, so please check the recommendations from your health care administration. But generally it is recommended that only persons with symptoms suggestive for CoVid 19 shall be tested.

© Dr Dietmar Schlembach

Generally, pregnant women do not appear to be more severely unwell than the general population if they develop COVID-19. As this is a new virus, how it may affect you is not yet clear. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

The large majority of women will experience only mild or moderate cold/flu like symptoms. Cough, fever and shortness of breath are other relevant symptoms. More severe symptoms such as pneumonia and marked hypoxia are widely described with COVID-19 in older people, the immunosuppressed and those with long-term conditions such as diabetes, cancer and chronic lung disease.These symptoms could occur in pregnant women so should be identified and treated promptly. Within the general population there is evolving evidence that there could be a cohort of asymptomatic individuals or those with very minor symptoms that are carrying the virus, although the incidence is unknown.

 

If you are pregnant you are more vulnerable to getting infections than a woman who is not pregnant. If you have an underlying condition, such as asthma or diabetes, you may be more unwell if you have coronavirus. If you develop more severe symptoms or your recovery is delayed this may be a sign that you are developing a more significant chest infection that requires enhanced care.

Therefore the general advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team.

Does a corona positive tested pregnant woman automatically transmit the virus to her baby?

There is currently no evidence of intrauterine fetal infection with COVID-19, meaning that it is very unlikely that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission). Two cases of possible vertical transmission have been reported. In both cases, it remains unclear whether transmission was prior to or soon after birth. It is also considered unlikely that if you have the virus it would cause abnormalities in your baby and none have been observed currently.
Some babies born to women with symptoms of COVID-19 in China have been born prematurely. It is unclear whether COVID-19 caused this or the doctors made the decision for the baby to be born early because the woman was unwell.
Furthermore, there are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19.

Why is it possible that fathers cannot take part in their babies delivery because of corona?

As this is a very new virus we are just beginning to learn about it: this recommendation/restriction does vary from country to country and also from hospital to hospital within one region / city. We are asked to slow down the speed of infection by physical distancing and the hospital or health care authorities recommending not to allow the father-to-be in the delivery room / hospital do so in order to reduce the infection risk for the medical staff and other patients.

How should we deal with the visiting ban regarding proud grandparents or relatives who would like to see the newborn?

Please accept that and explain that to your family – especially your parents. Older people are at increased risk for severe form of the disease and at higher risk for dying because of the infection.

If I would become grandpa, I would like to see my grandchild too, but even more I would love to see this child, when it grows up and actively recognizes me. On the other hand I would hope for your baby, that it may get to know its grandparents at an older age and not just as a nursling and avoid to be told, that the grandparents died, because they (were) visited by potentially infected relatives.

Please, there’s enough social media possibilities to become acquainted with each other and I am asking you to use these possibilities. Not doing so, might be a matter of life and death.

Are there specific precautionary measures for pregnant women?

No more than to all other people. Please strictly pay attention to personal hygiene (washing your hands) and avoid close contact to other people (even if it might be difficult, especially when you have children).

Note: To avoid infection with COVID-19 it is advisable to frequently wash your hands. If you want to promote handwashing in your organisation, find useful materials such as posters, flyers and colouring pictures at: https://www.efcni.org/activities/campaigns/wash-your-hands/

 

For further information about COVID-19 you might also want to read the following articles:

You can also find Frequently Asked Questions  (FAQ ) about COVID-19 concerning maternal and newborn health on the website of GLANCE, the Global Alliance for Newborn Care, a new global initiative, founded and coordinated by EFCNI