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

[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.”

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

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 mothersSomething to watch out for!

CHR’s COVID-19 Bulletins

  1. COVID-19 accelerating the changing practice of assisted reproduction (published on October 16, 2020)
  2. [Preprint by Norbert Gleicher, MD] COVID-10 pandemic through the eyes of a New York City fertility center (published on August 20, 2020)
  3. News you, likely, will not find in the media (Published on July 6, 2020)
  4. Notable reports in medical literature and the media on COVID-19 and immunity against it (Published on July 6, 2020)
  5. COVID-19 cases rapidly increase in South and Western U.S. states but that will help build herd immunity (Published on June 29, 2020)
  6. Are we witnessing a second wave of COVID-19 outbreak? (Published on June 22, 2020)
  7. WHO was wrong about asymptomatic patients being contagious & other COVID-19 fake news (Published on June 10, 2020)
  8. Updated COVID-19 precautions at CHR (Published on June 9, 2020)
  9. What we now know about COVID-19 and what it means for mitigation strategies (Published on May 22, 2020)
  10. COVID-19 response in retrospect, as well as going forward (Published on May 7, 2020)
  11. The essence of the COVID-19 pandemic (Published on May 7, 2020)
  12. Practical consequences of COVID-19 for CHR’s fertility patients (Published May 7, 2020)
  13. IVF after COVID-19: ASRM and SART release reopening guidelines for IVF centers (Published on 4/29/2020)
  14. One medical expert, missing from all COVID-19 task forces, who should be listened to (Published on 4/29/2020)
  15. Governments worldwide should have let herd immunity develop rather than cause one of the worst recessions on wild guesses of “experts” (Published 4/27/2020)
  16. Reciprocal collaboration among IVF centers for cycle monitoring may be on the wane (Published 4/22/2020)
  17. Is embryo freezing better than IVF during COVID-19 outbreak? (Published on 4/17/2020)
  18. When to restart fertility treatments after COVID-19 (Published on 4/17/2020)
  19. “Reopening” of fertility centers after COVID-19: How that may look like (Published on 4/17/2020)
  20. Some IVF centers may never reopen (Published on 4/17/2020)
  21. Skepticism warranted for “expert opinions” on COVID-19 (Published on 4/13/2020)
  22. Fertility Providers’ Alliance tries to reframe ASRM’s reaffirmation of COVID-19 guidelines as FPA victory (Published on 4/6/2020)
  23. States in the Northeast may see first signs of “flattening the curve” (Published on 4/6/2020)
  24. Reported death rate exaggerated by the media, shelter in place or herd immunity, first COVID-19 antibody test approved, and more (Published on 4/3/2020)
  25. What can I do to continue on my fertility journey? [VIDEO] (Filmed on 3/26/2020, published on 4/2/2020)
  26. “Controversy” over ASRM recommendation hints at investor interest’s power grab amid COVID-19 pandemic (Published on 4/2/2020)
  27. Pregnant women concerned over delivery and babies during COVID-19 pandemic (Published 4/1/2020)
  28. ASRM’s COVID-19 Task Force reaffirms previous recommendations (Published 4/1/2020)
  29. To stay open or not: IVF centers argue over ASRM guidelines on COVID-19 and fertility treatments (Published 3/27/2020)
  30. Concerning news on COVID-19’s effects on pregnancy and newborn (Published 3/27/2020)
  31. What’s urgent is urgent and what’s not urgent isn’t: Explaining ASRM recommendations on fertility treatments during COVID-19 pandemic (Published 3/26/2020)
  32. Patient autonomy and “do no harm” principles mean CHR continues to offer fertility diagnosis and treatments during COVID-19 crisis (Published 3/23/2020)
  33. ASRM and SART’s recommendations on fertility treatment during COVID-19 outbreak (Published 3/18/2020)
  34. CHR’s response to the COVID-19 outbreak: What we are doing to protect our patients, staff and community (Published 3/13/2020)
  35. Does COVID-19 have an effect on fertility? (Published 3/13/2020) 
  36. What happens if I get quarantined during an IVF cycle? (Published 3/13/2020)
  37. What happens if CHR is closed for quarantine during my IVF cycle? (Published 3/13/2020) 
  38. What should fertility patients do during the coronavirus outbreak? (Published 3/13/2020) 
  39. Should international patients of IVF do anything differently during the outbreak? (Published 3/13/2020) 
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.