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COVID-19 During Pregnancy

By

Lara A. Friel

, MD, PhD, University of Texas Health Medical School at Houston, McGovern Medical School

Last full review/revision Jun 2021| Content last modified Jun 2021
Click here for the Professional Version
  • Based on available information, the risk of getting COVID-19 seems to be similar for pregnant women and other adults.

  • Some evidence suggests that COVID-19 is more likely to cause severe illness in pregnant women who have symptoms of COVID-19, particularly if they have certain conditions (such as diabetes or heart disease), than in people who are not pregnant.

  • The risk of problems during pregnancy (such as preterm labor, birth of a premature newborn, and preeclampsia) may be increased if symptoms are moderate or severe.

  • Doctors suspect COVID-19 based on symptoms and the likelihood of exposure, but tests are needed to confirm the diagnosis.

The risk of a pregnant woman transmitting COVID-19 to the fetus appears to be very low. But once the baby is born, person-to-person spread is possible.

Symptoms of COVID-19 During Pregnancy

Most people with COVID-19 have mild or no symptoms, but some become severely ill and die. Symptoms can include fever, cough, and shortness of breath. Occasionally, loss of smell or taste can be the first symptom.

Whether pregnancy increases the risk of having severe symptoms has not been established. However, some evidence suggests that COVID-19 is more likely to cause severe illness in pregnant women, particularly if they have certain conditions (such as diabetes or heart disease). Women with severe illness may require hospitalization, intensive care, and/or a ventilator.

Diagnosis of COVID-19 During Pregnancy

  • A doctor's evaluation

  • Tests to identify the virus

Diagnosis of COVID-19 in pregnant women is similar to diagnosis in people who have COVID-19 and are not pregnant Diagnosis Coronaviruses are a large family of viruses that cause respiratory illness ranging in severity from the common cold to fatal pneumonia. There are many different coronaviruses. Most of them cause... read more . COVID-19 is suspected if people have a fever, a cough, sudden loss of smell or taste, and/or trouble breathing and they could have been exposed to the virus.

To confirm the diagnosis, doctors may take samples of fluids from the respiratory tract to be tested. Polymerase chain reaction (PCR) techniques can help doctors identify the virus. This tests can be used to make many copies of the virus's genetic material and thus make identification easier. If a test is not readily available or if symptoms are mild, the diagnosis may be based on symptoms and likelihood of exposure (if it can be determined).

If needed, chest x-ray and/or computed tomography (CT) is done.

Prevention of COVID-19 During Pregnancy

The best way to prevent COVID-19 is to avoid being exposed to the virus, which can be difficult because some infected people do not know they have the virus. The Centers for Disease Control and Prevention (CDC) has issued recommendations for preventing the spread of COVID-19. These recommendations apply to all people (see also Prevention of COVID-19 Prevention Coronaviruses are a large family of viruses that cause respiratory illness ranging in severity from the common cold to fatal pneumonia. There are many different coronaviruses. Most of them cause... read more ).

In addition, pregnant women should call their health care practitioner to determine whether they can have fewer prenatal visits and visits for testing (such as for blood or urine tests or ultrasonography). Reducing the number of visits can reduce the risk of exposure to COVID-19. For example, instead of a visit, women can talk with their health care practitioner on the telephone or have an online video call (telemedicine).

If fetal monitoring is needed, practitioners can sometimes do it in a way that requires less contact between health care practitioners and the woman. For example, they can monitor the fetus from outside the examination room electronically or with Bluetooth, although they must enter the room to attach the monitor.

If a pregnant woman may be infected, separating her from her baby after delivery may be necessary until doctors determine whether the baby is infected.

COVID-19 Vaccine

Whether the COVID-19 vaccines are safe for or effective in pregnant women, the fetus, and the newborn is unknown at this time because studies in these groups have not been done. However, most experts recommend that pregnant women talk with their doctor about the COVID-19 vaccine and their situation. Then they can decide whether they wish to get it. Having a condition that increases the risk of severe illness is one factor for pregnant women to consider.

Breastfeeding

The risk of a mother transmitting the virus through breast milk is low or nonexistent. But more information is needed to determine whether an infected mother can pass the virus to the baby in breast milk. If a mother wants to breastfeed her baby, she should do the following unless the health care practitioner has determined that she is not infected:

  • Wash her hands before preparing to breastfeed and before touching any breast pump or bottle parts.

  • Express milk to be taken and fed to the infant by a caregiver who is not infected.

  • Clean all pump and bottle parts after use.

  • Clean the pumping area, including the counter top, with disinfectant wipes.

  • If she chooses to breastfeed directly, wear a face mask and wash her hands before each feeding.

Treatment of COVID-19 During Pregnancy

  • Acetaminophen to relieve fever and muscle aches

Treatment of COVID-19 in pregnant women and people who are not pregnant is similar.

Acetaminophen may be used to relieve fever and pain, such as muscle aches.

Before delivery, pregnant women with COVID-19 should notify the hospital that they have the infection. Then the hospital staff can take the needed precautions to prevent spread of the virus.

More Information

The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  • American College of Obstetricians and Gynecologists: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients: This web site discusses how COVID-19 may affect pregnant women and the fetus, whether pregnant women should get a COVID-19 vaccine, how to avoid getting the virus, how to stay healthy during the pandemic, what to do if pregnant women think they have or if they get COVID-19, and how the pandemic affects their plans for labor and delivery. Breastfeeding and COVID-19 are also discussed. This web page is updated as new information about COVID-19 and pregnancy becomes available.

  • Centers for Disease Control and Prevention (CDC): Coronavirus (COVID-19): This web site provides links to information about the COVID-19 vaccines (including how to find a vaccine), the number and location of cases (including maps and charts tracking cases, deaths, and trends of COVID-19) in the United States, and recommendations about how to stay safe in schools and the workplace.

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Breast Pain
Breast pain (mastalgia) may be localized to a small area of one breast or be more generalized and felt throughout one or both breasts. Which of the following is NOT one of the more common causes of breast pain?
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