The Indian Council of Medical Research on Monday said emerging research suggests that transmission of the coronavirus from mother to child before birth, or at the time of delivery is possible, PTI reported. The proportion of pregnancies that could be affected, and its significance to the neonate, however, is yet to be determined.
“...Emerging evidence now suggests that vertical transmission [from mother to baby antenatally or intrapartum] is probable, although the proportion of pregnancies affected and the significance to the neonate has yet to be determined,” the medical body said. “Also, there is no evidence currently that the virus is teratogenic [causing developmental malformations],” it said, adding that long-term data for this is awaited.
The medical body said no cases of breast milk testing positive for the coronavirus have been recorded at present. There is also no data that suggests a correlation between miscarriage or early pregnancy loss and Covid-19, it added.
It also unknown whether newborns infected with Covid-19 are at an increased risk of facing severe complications. Transmission after birth via contact with infectious respiratory secretions is a concern, the ICMR said.
The medical body clarified that pregnant women do no appear to be more vulnerable to the Covid-19 infection than the general population. However, pregnancy itself alters the body’s immune system and its response to viral infections in general, which can occasionally be related to more severe symptoms, and this will be the same for Covid-19, it added.
In other types of coronavirus infection, such as severe acute respiratory syndrome coronavirus or the Middle East Respiratory Syndrome coronavirus, the risks to the mother appear to particularly increase during the last trimester of pregnancy, the medical body said. There are case reports of preterm birth in women with Covid-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.
Meanwhile, pregnant women with heart ailments are at the highest risk of contracting the coronavirus, ICMR said. The pandemic also amplifies the risk of perinatal anxiety and depression, as well as domestic violence, it added. “It is critically important that support for women and families is strengthened as far as possible; that women are asked about mental health at every contact.”
Issuing medical guidance for the treatment of pregnant women the ICMR asked hospitals to consider segregating a mother – who has Covid-19, or is a suspected case – from her child in separate rooms until the mother’s transmission-based precautions are discontinued. Obstetric units must also ensure that in such instances, the woman is appropriately isolated, it added.
Healthcare providers should create a plan to address the possibility of a decreased workforce, a potential shortage of personal protective equipment, limited isolation rooms, and should maximise the use of telehealth for prenatal care, the medical body said.
The recommendations are based on guidelines from international disease control agencies and publications, and have been simplified for Indian context, the document stated. It is further based on the limited evidence available to date about transmission of the virus that causes Covid-19, and knowledge of other viruses that cause severe respiratory illness including influenza, severe acute respiratory syndrome coronavirus, and the Middle East Respiratory Syndrome coronavirus, the ICMR said.