Issue link: https://viewer.e-digitaledition.com/i/1425002
Pregnant Women Positive for COVID-19: BY K ATE STEINMETZ CLINICIANS SPENT OVER A YE AR RESE ARCHING THE UNIQUE RISKS OF INFANTS BORN TO WOMEN WITH A CONFIRMED SARS-COV-2 INFECTION. WHILE SOME DANGERS HAVE BEEN IDENTIFIED, OTHER STUDY FINDINGS ARE PROMISING. LAST YEAR, PREGNANT women made up one-quarter of women ages 15 to 49 years old hospitalized with COVID-19 between March 1 and Aug. 22, according to the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET). During the early stages of the pandemic, little was known about how this new disease would impact pregnant women and newborns. Now, several studies have emerged that establish evidence-based recommendations for standards of care. BAD NEWS: POSSIBLE INCREASED RISK OF PREMATURE BIRTH Pregnant women who become ill with COVID-19 may be at increased risk for having a premature birth. According to the CDC's Morbidity and Mortality Weekly Report, out of 445 births reported, 12.6% of infants were born premature in women hospitalized with COVID-19. The CDC states this rate is approximately 25% higher than the rate of premature birth in women without COVID-19. W hi le more studies a re needed to understand why premature births are occurring more frequently in patients with COVID-19, researchers urge health- care providers to counsel women on the potential link of severe COVID-19 ill- ness and adverse pregnancy outcomes, as well as educate them on strategies to prevent infection. GOOD NEWS: LOW RISK OF COVID-19 TRANSMISSION AFTER BIRTH I n e a rl y 2 0 2 0 , w om e n w it h a c t i v e COV I D -1 9 i n fec t ion s who ju s t gave bir th were advised to isolate from their newborn for t wo weeks a nd a sked not t o brea s t fe e d . T he se re c om mend a- t ion s c a me out of l it t le k nowle d ge of t he i l l ness a nd fea r of t he mot her tra nsferring the v ir us to the newborn. With g reater knowledge ava i lable, the g uidelines have cha nged. One obser- v at ion a l c ohor t s t udy publ i s he d i n T he Lancet Child & Adolescent Health w a s i n s t r u ment a l i n c h a n g i n g t he g uidelines by discovering more about neonata l ma na gement a nd outcomes during COV ID -19. "This is a respiratory illness that is transmitted through respiratory droplets," says Christine M. Salvatore, MD, Chief of the Division of Pediatric Infectious Diseases at Weill Cornell Medicine and NewYork-Presbyterian. "With the small experience [we] had with other coronavi- ruses, we knew that transmission through the womb or breast milk was very rare. However, you cannot base a hypothesis on assumptions. You need to study it to ensure you are correct." Dr. Salvatore, a contributing author to the study, and her colleagues created a clinic for babies born to mothers with COVID-19. They had three goals in mind: 1) to care for mothers with COVID-19 who may be turned away from other pediatri- cian offices because of the active illness; 2) to implement best infection control practices; and 3) to identify potential risk factors associated with transmission. What Does It Mean for Newborns? 2 2 SPECIAL CLINICAL SECTION: PEDIATRICS