Covid-19 and pregnancy
As Covid-19 is a relatively new disease, there is little information on the health risks of Covid-19 for the mother-to-be and the unborn baby.
Covid-19 infection : What is known today ?
The following data are based on the literature to date and will evolve as knowledge of this pandemic increases.
It seems prudent to consider pregnant women as a potential risk group for SARS-CoV-2 infection.
Are pregnant women at greater risk of infection with the new coronavirus ?
The number of cases of SARS-CoV2 infection is comparable between pregnant women and the general population. Therefore, it does not appear that pregnant women are more likely to be infected with this virus than non-pregnant people.
Are pregnant women more likely to develop a severe form of the disease ?
The symptomatology of Covid-19 infection in a pregnant woman is not different from that described outside of pregnancy. Fever and cough are often reported.
Cases requiring hospitalisation with oxygen therapy have been reported with a slightly increased rate compared to non-pregnant women of childbearing age. However, there is no demonstrated excess risk of mortality in sick pregnant women.
The risk factors are :
- maternal age > 35 years
- obesity
- history of diabetes
- history of pre-eclampsia
What are the obstetric risks of Covid-19 infection during pregnancy ?
The course of the disease for an expectant mother is the same as for a woman who is not pregnant, but pregnancy can complicate management if there are significant symptoms.
The main risk for pregnant women with Covid is premature delivery.
What about fetal risks ?
To date, no malformations have been described in pregnant women with Covid-19 infection.
Is there a risk of maternal-foetal transmission of Covid-19 ?
Transplacental fetal contamination seems to be exceptional. The few cases of neonatal infections observed correspond rather to post-natal contamination than to contamination before delivery. Maternal-fetal contamination remains possible but seems to be exceptional.
What about vaccination of pregnant women against Covid-19 ?
Vaccination protects the mother-to-be and indirectly the baby. Indeed, the antibodies produced after vaccination are transmitted to the baby.
The recommendations of the Conseil Supérieur des Maladies Infectieuses (CSMI) are to vaccinate pregnant women with an mRNA vaccine against Covid-19 from the 10th week of amenorrhea (report of 29 March 2021). According to this report, there is no risk to pregnant women or their babies.
When to carry out a serological test or a PCR test in a laboratory ?
The serological test
Serology allows us to know (from a blood sample) if there has been an immune reaction of the blood cells following contact with the virus or following vaccination.
The antibodies detected are directed against a subdomain (RBD) of the Spike protein (S1) which is responsible for the entry of the virus into the cells. These antibodies are produced after vaccinations or after natural infection.
At the Ketterthill Laboratory, the rate is positive if it is higher than 60UA/ml. The positivity rates vary according to the suppliers’ kits.
The serological test can be used to verify contact but does not indicate the date of infection.
Antibodies appear 5 to 40 days after a stimulation (infection or vaccination). The antibody level does not define a state of protection, nor does it determine whether a person is contagious or not.
PCR test
PCR is used to test for the virus’ RNA. In case of suspected infection, it is the reference test.
Please note : Antigenic tests are not performed at the Ketterthill Laboratory.
In summary
- The risk to babies is low
- Maternal-fetal transmission is exceptional
- No known malformations
- The major risk is premature bith
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