Pregnant women concerned about impact of COVID-19 on delivery and their babies

Data on COVID-19's effects on pregnant mothers, deliveries and babies are still scarce. Image by Jonathan Borba, via Unsplash.

[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 31, 2020 and published on April 1, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.]

NPR ran a story, not surprisingly, suggesting that many pregnant women are concerned about the potential COVID-19 impacts on their pregnancies. Their discomfort with the situation is understandable: The medical data on the effects this virus may have on pregnancy and offspring are currently still very limited. Most come from China, and it has become apparent in other areas of reporting that Chinese data do not always coincide with what is observed in U.S. patients. Maureen Phipps, CEO of the American College of Obstetricians and Gynecologists, recently summarized the situation well when stating: “The reality is we don’t have a lot of data related to outcomes in pregnancy in women who have COVID-19 or their risk of contracting COVID-19, and that does put us at a disadvantage.”

The perinatal program at Columbia University just preliminarily reported 6 deliveries in COVID-19-positive women, with two of the mothers getting very sick after their deliveries, requiring admission into Intensive Care Units. All 6 babies were, however, not infected by the virus and that is good news.

That 2 of 6 women got very sick after delivery is an interesting observation because postpartum flares of diseases are a characteristic finding in autoimmune diseases. As now has been increasingly apparent from data developed here in the U.S. and elsewhere, the reason why some people get such a horrible pneumonia from COVID-19 is not damage the virus causes in the lungs but the overreaction of the patients' immune system to the virus, which unleashes a so-called cytokine storm. Cytokines are substances released by immune cells to fight invaders, including viruses. In cases of cytokine storms, this immune response, however, gets out of control and attacks the hosts' own tissues, in this case the patients' lungs. U.S. data have now also demonstrated that the lung is not the only target. Other organs may also be affected, especially the heart.

That two women suddenly became very sick postpartum, therefore, may suggest that, like in autoimmune diseases, the end of pregnancy may represent the beginning of a high-risk period for mothers. Something to watch out for!

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Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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