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UF Health physician sifts facts from fears about COVID-19 and pregnant women

Pregnancy is already a stressful time for many women. With the spread of COVID-19, many expectant women are worried about what the virus means for their health and the health of their baby.

John Smulian, M.D., M.P.H., chair of the UF College of Medicine’s department of obstetrics and gynecology and the B.L. Stalnaker professor provides some important information on what is known about the novel coronavirus and pregnancy.

Q. Are pregnant women more susceptible to contracting COVID-19?

There is currently limited information regarding COVID-19 and pregnancy. However, available reports suggest that pregnant women are not more likely to become infected than non-pregnant individuals with similar characteristics. There is no evidence that pregnant women with COVID-19 have a more severe disease course than others. If a pregnant women develops severe symptoms from COVID-19, there may be an increased chance of an early delivery or cesarean delivery in the third trimester, which is similar to what is seen with severe influenza infections. There have been no reports so far of an association of COVID-19 with early miscarriage rates or birth defects. Available information suggests that the virus is more likely to affect (and more likely to be severe in) older individuals. In addition, there are more males who have developed an infection than females.

Q. Can COVID-19 be transferred from mother to baby?

There are several scientific articles describing a small number of pregnancies affected by COVID-19. Most of the babies showed no signs of transmission from the mother. Recently, there have been reports of several babies from mothers with COVID-19 who had testing results that suggested the possibility of a COVID-19 infection. However, the circumstances of those tests makes it difficult to determine if there was actual infection present. Because of this, we still do not have proof that the virus can be transmitted to the baby while still inside the mother. Nevertheless, it remains a possibility. More research is needed to determine whether this kind of transmission can occur. What we do know is that a mother or caretaker who has the COVID-19 infection can potentially transmit the virus to an infant after the baby is born if proper hygiene precautions are not taken to limit that child’s exposure.

Q. When should a pregnant woman contact her doctor if she is having symptoms of COVID-19?

It is reasonable to contact your doctor or other health care provider for advice if you have symptoms of a viral illness such as a fever, persistent cough, difficulty breathing, generalized aches and chills. Other symptoms, such as sore throat, headache, diarrhea and nausea are much less common with COVID-19. As of now, the most common explanation for these symptoms is the common flu virus and not COVID-19. However, if you develop symptoms and have a history of recent travel to areas where COVID-19 is more common, if you have been exposed to someone who may have COVID-19 or if your symptoms are getting progressively worse, you should let your health care provider know right away. It is recommended that you call your health care provider first for advice before considering a visit to an emergency room.

Q. What are the restrictions on visiting the new baby and mother?

Although the delivery of a new baby is an exciting time for mothers, fathers, family and friends, our current concerns about the potential spread of COVID-19 in the community have led our department to put safeguards in place to help protect everyone. As part of this process, we believe it is important to limit visitors in the hospital to no more than one designated individual who has no symptoms or risks for having the COVID-19 infection for the duration of the hospital stay. Only this single designated person may be present at the bedside at any given time, including for delivery and the postpartum stay. Visitation may be further limited depending on individual circumstances, especially if there is a suspected COVID-19 infection. Similar to other hospitals across the United States, we have adopted these policies to keep our mothers and babies safe.

Q. Is it safe for a woman to come to the hospital to deliver her baby?

It is still very safe for mothers to delivery their babies in the hospital. The most common and serious complications of a delivery do not involve COVID-19 and require the expertise of a team that is experienced in the management of all levels of care. Our doctors, midwives and staff are all focused on delivering high-quality care in an environment that provides safety from the more common complications of delivery, as well as conditions such as COVID-19. We do not recommend alternatives to a hospital-based delivery.

Q. Is there any additional information pregnant women need to know around COVID-19?

COVID-19 is a serious infection for our community, state, country and the world. The spread of the virus in our area has not yet accelerated as it has in other locations, but that is expected to change very soon. The best recommendations to protect yourself include social distancing, limiting all but essential travel, avoiding mixing with groups of individuals, good hand hygiene with soap and water (20 seconds) or hand sanitizer (>60% alcohol), and cough etiquette (covering mouth with tissue or bend of arm). We also recommend that you follow recommendations of your health care team regarding care. In times of concern about a spreading virus, your providers may suggest alternative methods of receiving more routine care through telephone or video evaluations, for times when an actual visit may not be critical to ongoing care. Know that regardless of the method of care, we are here to continue to serve our patients and community safely during pregnancy, delivery and beyond.

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