The Latest: CDC’s Updated Research on COVID-19 and Pregnancy
WHEW - information is changing at the speed of light these days. While this will likely be out of date before you finish reading it, I know all you soon-to-be mamas are doing your best to stay current on information related to your upcoming birth.
Below I’ve included information from the Centers for Disease Control and Prevention as well as a recent study from New York of 43 pregnant women who tested positive for COVID-19.
Changes to the CDC’s Guidelines:
Revisions were made in relation to the decision of whether to keep a mother with known or suspected COVID-19 and her infant together or separated:
Revision made April 4: decisions should be made “on a case-by-case basis, using shared decision-making between the mother and the clinical team.”
The CDC’s earlier guidance (now outdated) from February stated, “To reduce the risk of transmission of the virus that causes COVID-19 from the mother to the newborn, facilities should consider temporarily separating (e.g., separate rooms) the mother who has confirmed COVID-19 or is a PUI from her baby until the mother’s transmission-based precautions are discontinued.”
The language in that earlier guidance was widely interpreted as the CDC recommending separation, although rooming-in was still possible in accordance with the mother’s wishes.
In their April update, the CDC has shifted toward a more neutral stance on mother-baby separation and draws attention to the need for shared decision-making.
They also added: “The many benefits of mother/infant skin-to-skin contact are well understood for mother-infant bonding, increased likelihood of breastfeeding, stabilization of glucose levels, and maintaining infant body temperature and though transmission of SARS-CoV-2 after birth via contact with infectious respiratory secretions is a concern, the risk of transmission and the clinical severity of SARS-CoV-2 infection in infants is not clear.”
Evidence Based Birth® has created a form for refusal to separate birthing parents and infants using revised language from the CDC. Access the form here.
Case Series of 43 Pregnant Women in NY with COVID-19
A case series from New York of 43 women who tested positive for COVID-19 was published on April 9 (Breslin et al. 2020).
Infection was often asymptomatic (14 out of 43 women, 33%), leading the authors to recommend universal testing of pregnant people being admitted to the labor unit. Of the asymptomatic women, 10.14 (71%) developed symptoms over the course of their admission or shortly after discharge.
The majority of women (60%) had a body mass index of 30 or greater. Many of the women (42%) had an additional comorbid condition (most commonly asthma).
The women showed a similar pattern of disease severity to non-pregnant adults: 86% mild, 9% severe and 5% critical, although the sample size was too small to make a direct comparison.
Newborns were tested on the first day of life and there were no confirmed cases of COVID-19. All 18 infants who were born during the case series had had Apgar scores ≥7 at 1 minute and ≥9 at 5 minutes.
Healthy newborns roomed in with their mothers whenever possible, using an isolette in the mother’s room. If rooming in was not possible, they were cared for in a separate nursery for infants of COVID-19 positive mothers. While rooming-in, mothers were asked to perform hand hygiene, wear a surgical mask at all times, and stay six feet away from their newborns except while breastfeeding. Breastfeeding was encouraged.
All 18 infants, including three who were initially admitted to the NICU for conditions unrelated to COVID-19, have since been discharged home.
Looking for more information?
John’s Hopkins COVID-19 Dashboard
Institute for Health Metrics and Evaluation’s COVID-19 Projector
Coronavirus (COVID-19) Symptom Checker
Pregnancy Birth & Baby: COVID-19 and Pregnancy
Evidence Based Birth COVID-19 Resource Page (my personal fav for all things pregnancy and birth!)
Knowledge is power… now go on…be your beautiful, knowledgeable self.
