This sheet is about having a COVID-19 infection in pregnancy and while breastfeeding. This information is based on available published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is COVID-19?
COVID-19 (Coronavirus Disease 2019) is an illness caused by a virus called SARS-CoV-2. The virus spreads mostly by close person-to-person contact. When an infected person breathes, talks, coughs, or sneezes, the virus can spread to others who are nearby.
The most common symptoms of COVID-19 include fever, cough, and shortness of breath. Other symptoms might include chills, muscle or body aches, headache, sore throat, new loss of taste or smell, runny nose, nausea or vomiting, and diarrhea. Some people have only mild symptoms or no symptoms at all (are asymptomatic), but they could still spread the virus to other people.
Women who are pregnant or were recently pregnant have a higher chance of getting very sick if they get COVID-19. Studies have shown higher chances of hospitalization, admission to the intensive care unit (ICU), and death from COVID-19 during pregnancy.
How can I help prevent getting COVID-19?
Staying up to date with recommended COVID-19 vaccines is the best way to protect yourself and others from COVID-19. MotherToBaby has fact sheets about COVID-19 vaccines at https://mothertobaby.org/fact-sheets/covid-19-mrna/ and https://mothertobaby.org/fact-sheets/covid-19-protein-subunit-vaccine/.
Other ways to help protect yourself and others include wearing a mask in public, avoiding large indoor gatherings, avoiding contact with people who might have COVID-19, and washing your hands often. The Centers for Disease Control and Prevention (CDC) has information about prevention at https://www.cdc.gov/covid/prevention/index.html.
What should I do if I get sick with COVID-19 while I am pregnant?
If you are pregnant and have symptoms of COVID-19 or test positive for COVID-19, be sure to tell your healthcare team. Your healthcare provider might recommend an antiviral medication to help lower the chance of getting very sick. Antiviral medications work best if taken early in the course of the illness. MotherToBaby has a fact sheet about one kind of antiviral medication used for COVID-19 at https://mothertobaby.org/fact-sheets/nirmatrelvir-ritonavir-paxlovid/. You can also talk to your healthcare provider about the best way to treat symptoms such as fever (see the section of this fact sheet about birth defects and fever for more information). While you are sick, stay home and avoid close contact with others to help prevent passing the virus to other people.
I have COVID-19. Can it make it harder for me to get pregnant?
It is not known if having COVID-19 can make it harder to get pregnant.
Does having COVID-19 increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies on COVID-19 infections in pregnancy have not suggested a higher chance of miscarriage compared to the general population.
Does having COVID-19 increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like COVID-19, might increase the chance of birth defects in a pregnancy. Some studies have observed higher rates of some kinds of birth defects in infants born to women with a COVID-19 infection in pregnancy. Other studies have not found a higher chance of birth defects. Overall, the research does not find a clear link between COVID-19 and any specific birth defect or pattern of birth defects.
Fever is a possible symptom of COVID-19. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended to reduce fever in pregnancy. If you get sick with COVID-19 or any other illness and develop a fever, talk with your healthcare provider to confirm if taking acetaminophen is okay for you. For more information about fever and pregnancy, see the MotherToBaby fact sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.
Does having COVID-19 increase the chance of other pregnancy related problems?
Studies have shown that women who are pregnant or recently pregnant and get COVID-19 have higher chances of becoming very sick, being admitted to intensive care, and needing to be put on a ventilator (machine that helps you breathe). Some studies have also reported a higher chance of death. The chance of these outcomes can be higher among women who also have other underlying health conditions, such as obesity, pre-pregnancy diabetes, and/or chronic hypertension. Just as in the general population, pregnant women who are up to date on COVID-19 vaccines are less likely to get infected, and less likely to get severely ill, be hospitalized, or die from a COVID-19 infection.
Studies have reported higher chances of pregnancy-related problems following COVID-19 infection in pregnancy, including preterm delivery (birth before 37 weeks of pregnancy), stillbirth, preeclampsia (dangerously high blood pressure), blood clots, and the need for an emergency c-section. Some studies suggest the virus can infect the placenta (a condition called placentitis) or cause changes to the placenta, which can lead to problems with how well the placenta works to support the pregnancy and fetal growth and development. Having COVID-19 might also make it harder to manage other health conditions that are common in pregnancy, such as other infections or high blood pressure. Women who are up to date with COVID-19 vaccines in pregnancy are less likely to experience pregnancy complications from a COVID-19 infection than women who are not up to date.
Can the virus that causes COVID-19 pass to the fetus during pregnancy or at the time of delivery?
The virus can pass from a woman who is pregnant to the fetus during pregnancy, but this appears to be rare. The chance of the baby getting the virus during or soon after birth might be higher if the pregnant woman has an active infection at the time of delivery. Most infants who test positive soon after delivery have only mild or no symptoms and fully recover from the virus. Severe illness might be more likely in infants who are born preterm or have other health problems.
Does having COVID-19 in pregnancy affect future learning or behavior for the child?
Studies have looked at the development of children born to women who had COVID-19 in pregnancy. A few studies have reported a higher chance of issues related to motor (movement) skills and speech and language in children up to 2 ½ years of age. Other studies have found no differences in development, learning, or behavior up to 2 years of age. Since many factors can affect children’s development (such as their home and school environment and other possible exposures in pregnancy), it is not clear if having COVID-19 in pregnancy affects long-term development in children.
Breastfeeding while having COVID-19:
The virus that causes COVID-19 has not been found to pass into breast milk. There have not been any reported cases of infants getting COVID-19 through breast milk. Women are often encouraged to continue breastfeeding or providing breast milk even when they are sick with a virus, such as the flu.
Women who are breastfeeding while sick with COVID-19 can help prevent passing the virus to their babies by washing their hands frequently and wearing a mask while nursing. They can also consider pumping milk for someone else to feed their baby while they recover. CDC has information on COVID-19 and breastfeeding at https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/covid-19.html. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man has COVID-19, could it affect fertility or increase the chance of birth defects?
A COVID-19 infection can cause a temporary decrease in the number and motility (movement) of sperm in some men. These changes in sperm could affect fertility (ability to get a woman pregnant). In most cases, the sperm are expected to return to normal after full recovery from the infection. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
MotherToBaby is currently conducting a study looking at COVID-19 in pregnancy. If you want to learn more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.
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