Pregnancy and birth can be stressful on a good day. But for many women giving birth during the coronavirus, fear and worry have overshadowed the joy and anticipation that accompanies childbirth. Yet, when we dig deep into the research and seek information from the most accurate sources, we find that that situation is not quite so bleak as it once seemed. So, let’s discuss the key pieces of good news for pregnant moms.
Women are less likely to experience serious symptoms from COVID-19.
Women tend to have stronger immune systems than men. This holds true with the female physical response to other familiar viruses as well, such as HIV and hepatitis C, where women tend to have a stronger immune response (1).
The research coming out from COVID-19 shows the same pattern. While both men and women are contracting the virus, women are less likely to suffer serious symptoms from the illness. For example:
- The Chinese Center for Disease Control and Prevention reported a death rate of 2.8% for men but only 1.7% for women (3).
- In Italy, of the 1,591 critically ill individuals involved in this particular study, 82% of the patients were men (4).
- According to the NYC Health COVID-19 Data report, as of 4/22/20, there were about 90 female deaths per 100,000 people and 156 male deaths per 100,000 people (5).
Why are women less likely to have serious COVID-19 symptoms than men?
There’s not a definitive answer on why women have a stronger immune response to viruses like COVID-19 than men do. However, there is some evidence that sex hormones (estrogen and testosterone) impact the body’s immune response (7). Or it could be due to fact that the X chromosome carries many immune-response genes. And fortunately, women have a double-dose of that immunity with their second X chromosome (8).
There is no evidence that pregnancy increases the severity of COVID-19 symptoms, unlike other viruses.
During pregnancy, a woman’s immune system is suppressed. If it were not so, your body might view your baby as a harmful pathogen and attack the baby, resulting in loss of the pregnancy.
Historically, pregnant women have been more vulnerable during viral outbreaks that affect the respiratory system. This is not only due to the immune suppression, but also because the growing baby pushes up on the diaphragm, reducing mom’s lung space. For instance,
- In the Spanish flu of 1918, pregnant women died at a significantly higher rate than non-pregnant women (5).
- Pregnant women are more likely to be admitted to the hospital and have serious symptoms from H1N1 compared with the general population (6)
Pregnant women are not at higher risk.
With this in mind, it’s understandable that the initial response from hospitals and care providers has been that of extreme caution. Fortunately, a similar trend is not emerging for pregnancy and COVID-19. According to the World Health Organization,
Data are limited, but at present there is no evidence that [pregnant women] are at a higher risk of severe illness than the general population.World Health Organization
Babies are less likely to be seriously affected by COVID-19.
No evidence of transmission during pregnancy.
Not only does the placenta help provide oxygen and nutrients to your growing baby, but is also acts as a powerful filter between your baby and infectious agents that could enter baby’s blood stream. And it seems to be working. The virus has not been found in the amniotic fluid, breast milk, or placentas of COVID positive women. To date, there has been no evidence that a COVID positive mother can transfer the virus to her baby during pregnancy (8).
While all age groups are susceptible to COVID-19, few cases of the virus have been found in children, who tend to have better outcomes and milder symptoms than older adults. And fortunately, even fewer cases have been observed in newborn babies.
Giving birth during the coronavirus: Exercise common sense and caution with your newborn.
Still, when giving birth during the coronavirus, it’s important to practice social distancing and frequent hand-washing around your newborn. And if mom is COVID positive, mom should wear a mask and consider having healthy family members care for baby. In the largest study to date involving pediatric patients and COVID-19, children under the age of 1 were more likely to develop severe symptoms than older children. It’s possible that infants, and especially premature newborns, may be at a higher risk of respiratory distress than other children (9).
Still, the relative risk of your newborn developing COVID-19 is low, and in general, children are experiencing milder symptoms than adults.
Giving birth during the coronavirus is a challenge, with hospital policies changing daily and new concerns being raised each night on the news. But mom, be reassured! You and your baby are at less risk to develop severe symptoms from COVID-19. Still, exercise caution. Stay home, wash your hands, try not to touch your face, and seek help if you have any symptoms of the illness. And above all, try to relax and enjoy the beauty of your pregnancy.
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(4) Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. Published online April 06, 2020. doi:10.1001/jama.2020.5394
(6) Centers for Disease Control. (2009). 2009 H1N1 Influenza Shots and Pregnant Women. Retrieved from https://www.cdc.gov/h1n1flu/vaccination/pregnant_qa.htm
(7) Taneja V. (2018). Sex Hormones Determine Immune Response. Frontiers in immunology, 9, 1931. https://doi.org/10.3389/fimmu.2018.01931
(8) Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet 2020; 395(10226): 809-15.
(9) De Rose, D. U., Piersigilli, F., Ronchetti, M. P., Santisi, A., Bersani, I., Dotta, A., Danhaive, O., Auriti, C., & Study Group of Neonatal Infectious Diseases of The Italian Society of Neonatology (SIN) (2020). Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far. Italian journal of pediatrics, 46(1), 56. https://doi.org/10.1186/s13052-020-0820-x