Pregnancy and birth in the time of a pandemic
When it comes to COVID-19 and pregnancy, there's a lot we don't know.
UBC's Dr. Deborah Money, professor in the faculty of medicine's department of obstetrics and gynaecology, is trying to fill that knowledge gap. She is leading a national surveillance study examining maternal and infant outcomes among pregnant women with COVID-19.
Money, who has been on the front lines supporting pregnant women through COVID-19 and past outbreaks, including H1N1 and SARS, discusses the national study and what we know about the risks of COVID-19 to pregnant women and their babies.
Why is a national study on pregnant women and infants with COVID-19 important?
When COVID-19 emerged, we faced a lot of questions about how best to advise pregnant women and maternal care providers but the data on how COVID-19 affects pregnancy was severely limited. We were basing Canadian guidelines on a limited set of data from China and relying on what we knew from past outbreaks, like SARS and MERS.
To help fill that knowledge gap, we set up a multidisciplinary network with experts across the country. Through the network, called CANCOVID-Preg, we will share findings both nationally and internationally to inform care and public policy around the world.
What do we know about pregnancy and COVID-19 so far?
Based on our knowledge of other viruses, like H1N1, pregnant women are more vulnerable to some respiratory infections compared to their non-pregnant peers. With COVID-19, we don't have any evidence to date to suggest that pregnant women are more at risk of developing the disease or severe complications. The impact of the virus on maternal health will be one aspect of our national study.
When it comes to how the virus affects the pregnancy itself, early reports from China indicated that 30 percent of babies born to mothers with COVID-19 were pre-term, with low birth weights. Later reports out of the U.S. suggested that those rates were much lower. While we don't think COVID-19 directly affects the fetus, it may indirectly affect the fetus by impeding growth and development. Infant outcomes will be another focus of our national study.
Can babies acquire the virus from the mother during pregnancy?
We don't think so, but this is very much in debate. As part of our national study, we'll be gathering more data about whether the virus can pass through the placenta during pregnancy, during or after birth.
Should babies born to mothers with COVID-19 be separated after birth?
In Canada, we are not advocating for the separation of mothers with COVID-19 from their babies at birth. In other areas, like the U.S., babies born to mothers who have COVID-19 are immediately separated. As the period immediately after birth is so critical for mother-infant bonding, the establishment of breast feeding, and for the overall mental health of the mother and baby, we believe that, with careful masking, handwashing and by modifying our behaviour, it's reasonable to have the mom and baby remain together.
Should women avoid getting pregnant during the COVID-19 outbreak?
We have not been advising against women getting pregnant. The decision is one that every woman will need to make based on their unique circumstances, including their work environment and exposure risk.
What challenges do pregnant women face today as a result of the outbreak?
The impact of the public health measures and limitations facing all of us right now present a unique challenge for pregnant women. All of the typical activities, like prenatal education and exercise classes, that help women stay connected and supported throughout their pregnancy are either not happening, or they're taking a very different form right now. When you're pregnant, family and friends also play such an important role in getting through the normal challenges of pregnancy, and so it's much harder for many pregnant women right now.