A question on transmission in pregnancy please...

[Luckystar1]

So the new guidance suggests that transmission through the placenta is ‘probable’ (although that appears to be only from one case).

Anyway, if a pregnant woman becomes infected, and if the infection passes to the foetus, what happens then?!

I’m 15 weeks pregnant, so, if I got it and it passed to the baby, and I recover, what happens the baby? Does it technically recover too?!

Thank you!

From RCOG:

There are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to
COVID-19. Case reports from early pregnancy studies with SARS and MERS do not demonstrate a convincing
relationship between infection and increased risk of miscarriage or second trimester loss.

There is no evidence currently that the virus is teratogenic. Very recent evidence has, however, suggested that it
is probable that the virus can be vertically transmitted, although the proportion of pregnancies affected and the
significance to the neonate has yet to be determined.

There are case reports of preterm birth in women with COVID-19, but it is unclear whether this was always
iatrogenic, or whether some were spontaneous. Iatrogenic birth was predominantly for maternal indications
related to the viral infection, although there was evidence of fetal compromise and prelabour preterm rupture
of the membranes in at least one report

Thank you, yes I read that from RCOG. It was more just a question of ‘what actually happens?’

I understand that it’s possible that a baby could be born with it, but at my gestation, does it transfer to the baby, and do they just get better when the mum does? (Or am I asking the unanswerable?!)

I think the answer is "they don't know" - there haven't been enough known cases where this has happened to be able to tell. It's encouraging, in a way, because I would think that if it did cause significant problems for pregnant women or their babies, that would surely have shown up by now. I would like to see them collecting more information though - maybe they are in the UK, but here they don't seem to be particularly collecting any information from pregnant women about whether they've had symptoms, the severity of those symptoms, anything like that. (Which is why the "we have no evidence/have no information about how this affects pregnant women" line irritates me, because of course you're not going to, if you never ask...)

Thanks Mum. That’s what I thought. I too am hopeful that the fact that they seem to not know is cautiously ‘good’ news, as there are so many infected, hopefully that info would’ve come out at some stage!

I'm concerned about this too as first trimester. I don't think I've had it but we did have a virus of some sort that was probably not Covid but who knows.

The problem is that most viruses that can be transmitted in utero in early pregnancy are teratogenic (cause birth defects) like rubella, Zika, CMV

Saying that, the evidence for transmission is weak and is being very specifically looked for. Who knows if other common viruses do act in the same way but the data isn't there yet as nobody looking for it.

Also even with Zika, less than 10% of babies infected developed defects (depending on stage). Generally viruses transmitted later cause less damage as the fetus is already formed, with the exception of some primary maternal infections very late on and just prior to birth.

Even though it sounds very scary, there's been no increase in problems on anomaly scans so far in Asia and I also think we'd know if it was causing big problems although of course we can't know for sure which is why the RCOG simply can't say.

But given most early evidence was that it was unlikely to be transmitted, it seems equally probable that a low percentage of pregnancies are affected.

Thanks Widow that makes sense to me. I have also had some sort of virus but I have no idea what it was, although my cough is persisting. But thankfully whatever it was seems to have been mild.

I hope you feel better and fingers crossed both us and the babies are ok!