Pregnancy & Coronavirus Worried

[TSMoma]

Hi, hopefully I’ve posted in the correct area.

I am currently 10 weeks pregnant with 1st baby after lots of endometriosis related heartache. This really is our miracle baby.
I am really anxious about Coronavirus- especially as there is no data about 1st or 2nd trimesters & the study published that said ‘no transmission between mother and baby’ was all from woman who were in such severe respiratory distress in the 3rd trimester their babies were delivered via emergency c sections. There just isn’t the data out there. I am fed up of seeing that ‘it’s no worse for pregnant women’ when really nobody knows. What we do know is in 1st trimester any raised body temp (fever) of the mother has been casually linked to foetal birth abnormalities.

I work in a school & other than ‘wash hands more’ (despite there not being adequate soap for the students) nothing else has been said. Children are also more likely to be asymptomatic carriers/have mild symptoms & I have a lot of experience of unwell children being sent in as parents can’t find alternative childcare (I’m not judging it just is what it is).

Anyone else in the same boat? I’m so anxious based on what is happening in the US & Italy (where they suspect the strain is stronger than the one in China). I don’t know whether to stay off work to keep my baby safe esp in this sensitive first trimester.

Thanks for responses in advance!

I'm in the same boat, only I've only just found out I'm pregnant (so, five weeks). I feel so abandoned by the NHS's non-advice for pregnant women (or others in vulnerable groups) and also so fed up of the "it's no worse than flu" brigade. I feel like the NHS tells us we can't drink alcohol, avoid too much caffeine, don't eat ham or brie, etc, yet this flipping deadly virus is circulating, which we hardly know anything about, and where a significant proportion of people are sufficiently ill to require hospitalising, and the best they can offer is 'wash your hands'. I work in a University, students are a notorious breeding ground for diseases anyway (fresher's flu) and many of them have travelled from overseas. I have international conferences coming up. I've no idea if I should avoid them, and I'm helping to organise parts of them. Unless the NHS says we should avoid these, it'll be hard to say no to what is a core part of my job. When you look at Italy's data it escalated so fast, and the death rate there is terrifyingly high, and the hospitals are already struggling. I feel the government is more concerned with managing panic to protect the economy, and people in vulnerable groups are just collateral damage to them.

The whole schtick from the experts is that pregnant women are at no higher risk of catching it or getting serious complications, and there's no vertical transmission. That's great, but not really the whole story. It doesn't tell us what the is risk to the pregnancy and the child if you do catch it (regardless of whether the child catches it), and the small studies (n=9) of women in late pregnancy had a lot of women giving birth prematurely (4 in one, 6 in the other).

Hi Nectarine,

A huge congrats on your little one!! I’m glad I’m not the only one feeling completely abandoned & let down. Sorry you’re going through it too. I agree 100% that there just isn’t enough data out there for them to be saying we shouldn’t be concerned. I also read the very small study with a critical eye & it just doesn’t apply to us in the 1st or 2nd trimesters. I think we have to do whatever keeps us and our bubs safe. For me that has meant getting the flu vaccine (won’t protect against Coronavirus but means flu can be ruled out quicker), avoiding large gatherings, refusing to remain in the prescence of visibly ill adults, working out my work term dates to alleviate some anxiety e.g only 3 weeks to go till a break. And above all putting myself and babe first! If anyone is continuing to come into my work place ill, if they won’t take the time off then I will to avoid contact with them. We really can’t be careful enough! I’m so hoping our U.K. gov will follow suite of other countries and close large educational establishments but they are dragging their feet! It’s irresponsible and selfish. I dread Easter as all the students will be flying around the world and bringing back different illnesses. I also don’t trust the U.K. data, they aren’t testing enough to have accurate numbers xx

Thanks TSMoma. That's a good idea about the flu vaccine. I've already had flu twice this winter (!) but there may be others in circulation. I'm taking vitamin D as well. Might ring NHS 11 as well and see what they say (although, I'd wager a tenner it'll be "just wash your hands more").

At the news conference yesterday they did say there was an increased risk for pregnant women and so I'm not sure who is saying there is no increased risk. Might be worth watching the news conference since I was only half listening whilst DS2 was gabbling about something.

I'm also really nervous about this, although I'm in the 3rd trimester, but still a worrying time. I did see that no more of a risk to pregnant woman, although can't think now where I've seen this? Is the risk from the fever that we may get with it? As I know a raise in temp can be dangerous?

Just read the RCOG guidance, which is a bit more reassuring:
www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/

However, also note Professor Hunter's comments:
www.bbc.co.uk/news/health-51774777

Rang GP surgery who said no point having flu vaccine when the season is nearly over.

NHS advice on pregnancy still virtually non-existent, basically wash your hands and if you've been in contact with someone with the virus call 111: www.nhs.uk/conditions/coronavirus-covid-19/common-questions/

Strange as I saw my midwife today who again asked did I have the flu vaccine (I already had) and she said they want all pregnant ladies vaccinated...I’ve been asked at every single drs appt recently

With regard to who is saying there is no risk, unfortunately a lot of GP’s are peddling that advice. My midwife today completely disagreed tho and said we are a higher risk category so absolutely avoid ill people as much as possible. It’s getting very confusing for those of us in education as a number of schools have had confirmed cases and remained open...the advice is all so conflicting!

The royal College of midwives published their report and guidelines into this issue yesterday.
We and our babies are at no greater risk according to them. www.rcog.org.uk/globalassets/documents/guidelines/coronavirus-covid-19-virus-infection-in-pregnancy-2020-03-09.pdf

Hello, me again. I don't want to sound alarmist, but I spent this morning reading through the actual research the RCOG advice is based on (apologies, but I'm a researcher - albeit not a medical one). I feel really uncomfortable about their approach. It is true that none of the very limited research on COVID19 in pregnancy has identified a specific increased risk of miscarriage, but there doesn't actually seem to be any research on this specific issue. So I can't see how they are ruling this out.

Meanwhile, although the RCOG guidance says that 'Case reports from early pregnancy studies with SARS and MERS [two much more lethal types of coronavirus] do not demonstrate a convincing relationship between infection and increased risk of miscarriage or second trimester loss', the actual study they cite to back up this claim is only of five patients (Zhang J, Wang Y, Chen L, et al. Clinical analysis of pregnancy in second and third trimesters complicated severe acute respiratory syndrome. Zhonghua Fu Chan Ke Za Zhi 2003;38:516-20). However a more recent review (Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections, by Schwartz and Graham, 2020) details several studies and concludes that there may be potential risks to both the mother and the child. A study of 7 women in their first trimester with SARS, for example, found that four had a miscarriage, and for those later than 24 weeks 4 had preterm deliveries.

A case series of 10 women with COVID 19 concluded 'Perinatal 2019-nCoV infection may have adverse effects on newborns, causing problems such as fetal distress, premature labor, respiratory distress, thrombocytopenia accompanied by abnormal liver function, and even death. However, vertical transmission of 2019-nCoV is yet to be confirmed.' (Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia, by Huaping Zhu and colleagues).

It feels to me that there are good reasons to be more cautious than the general population as you go about your business, unless more robust evidence emerges that there isn't a more severe risk to pregnancies (and pregnant mothers). It feels to me that they are applying a scientific paradigm of 'we won't advise caution unless there is really strong evidence of a risk', at a time when a more cautious paradigm should be adopted given what we know about the risks of other coronaviruses and also more generally conditions like flu and pneumonia that cause respiratory problems, fevers and can indeed be harmful in pregnancy.

What do others think? Just to reiterate one more time, I am not a medical researcher.