PREGNANT WOMEN AND COVID-19

Can a COVID-19 positive pregnant woman transmit the SARS-CoV-2 virus to her baby? Is the SARS-CoV-2 Virus transmitted during breastfeeding?

• The first published Chinese data seem to show that the symptoms in pregnant women are the same as those in the general population for the vast majority of them who would only experience mild symptoms of rhinitis or flu syndrome with potentially cough, a fever or dyspnea, but there is a risk that it will have more serious forms.
• Analysis of several results from clinical studies suggests that, at present, there is no evidence of intrauterine maternal-fetal transmission. One of the hypotheses that could explain the absence of maternal-fetal transmission via the placenta would be the fact that the SARS-CoV-2 receptor, the angiotensin converting enzyme (ACE2) necessary for its cellular integration, has a very weak at the maternal-fetal interface.
• However, cases of newborns infected early suggest that there could be vertical intrapartum or neonatal transmission.
• Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described.
• In addition, analysis of breast milk does not show viral excretion and therefore a priori no transmission via breastfeeding.
• Indeed, the SNF (French Society of Neonatology) and the GPIP (Pediatric Infectious Pathology Group) do not currently recommend separating the COVID-19 positive mother and her child and do not contraindicate breastfeeding. During breastfeeding, wearing a mask is obligatory for the mother (surgical mask) with strict hand hygiene measures, but no mask for children.
• It therefore seems important that pregnant women respect barrier measures and it is essential to be tested if symptoms appear.

References :

• PEYRONNET, Violaine, SIBIUDE, Jeanne, DERUELLE, Philippe, et al. SARS-CoV-2 infection in pregnant women. State of knowledge and proposed treatment. CNGOF. Gynecology Obstetrics Fertility & Senology, 2020.

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