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Last week, a three-day-old baby and his mother tested positive for COVID-19 in a private lab in Mumbai, but subsequently tested negative in Kasturba Hospital. It is still unclear whether a pregnant woman runs the risk of transmitting the virus to her baby during pregnancy. While there is no concrete evidence for vertical transmission of SARS-CoV2 from mother to foetus, it is known that pregnancy involves a risk, after birth, of adverse outcomes from many respiratory viral infections. A virus may be transmitted after delivery either from mother during breastfeeding or from the hospital environment, various experts have said.
The World Health Organization notes that there is no evidence yet to show that pregnant women are more vulnerable or are at a higher risk of severe illness from COVID-19 than the general population. It has, however, advised pregnant women to wash their hands frequently, to avoid crowded spaces and to practice respiratory hygiene.
Experts at the College of American Pathologists flagged this concern in the Archives of Pathology and Laboratory Medicine. They cite the recent history of vertical maternal-foetal transmission of such emerging viral infections as the Zika virus, Ebola virus, Marburg virus and other agents. A March 24 article in The Lancet Infectious Diseases Journal too flagged such concerns while noting that the potential risk of vertical transmission is unclear.
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In India, efforts have been made to create a pregnancy registry at the Indian Council of Medical Research. “Maternal management and foetal safety are a significant concern, but the infection is at a low level and there is not sufficient number of patients for our studies to assess the vulnerability of pregnant women and whether there was vertical transmission of COVID-19 virus to their babies,” Dr R R Gangakhedkar, Head of the Epidemiology and Communicable Diseases Division at Indian Council of Medical Research, told The Indian Express.
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At the ICMR’s pregnancy registry, obstetricians have been asked to provide information about any adverse outcomes. “`We have no evidence so far,” he said. One pregnant woman who had delivered at AIIMS recently had been detected with COVID 19. The stress is therefore on respiratory and personal hygiene, including handwashing, and social distancing. While feeding the baby the distance between the infant and the mother is too small, “hence here we can suggest that she can express her milk”, Dr Ganghakhedkar said.
So far no reliable evidence recommends any specific COVID-19 treatment for pregnant women. Before allowing drugs for pregnant women, clinical trials would be needed to prove the effectiveness of drugs and the effects on the foetus to establish a standardised treatment.
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