Canadian research network examining pregnancy and COVID-19
Best practices in part based on research into pregnancy and SARS and H1N1
Clinicians and epidemiologists don't yet know much about COVID-19 and pregnancy, says the leader of a newly formed national network that's examining maternal and infant outcomes among pregnant women who fell ill with the disease.
"We scoured the literature and found a real limited amount of information, of course, at the beginning, from China and a little bit more from Europe,'' said Dr. Deborah Money, a professor in obstetrics and gynecology at the University of British Columbia's faculty of medicine.
That early information ranged from "quite dreadful predictions of what might happen to much more benign,'' said Money, who is a sub-specialist in reproductive infectious diseases.
She's heading up the new network of physicians and researchers that seeks to close those gaps.
She said every province and territory has signed on to work with local public health departments and collect data.
"We're actually hoping to collect every single, solitary, identified COVID-19 positive pregnancy, regardless of when it happened, and collect it through the evolution of the pandemic,'' Money said in an interview on Friday.
Many variables at play
The network is focused on variables including the mother's age, the age of the fetus at the time of her COVID-19 infection, the severity of the infection and whether the mother required hospitalization or intensive care treatment.
It is also looking at what happens during delivery and whether the mother chooses to breast feed, as well as the newborn's weight, Money explained.
Some of Money's colleagues are exploring women's experiences of pregnancy during COVID-19 overall, regardless of whether they contracted the illness.
Money also sits on the infectious diseases committee for the Society of Obstetricians and Gynaecologists of Canada, whose members are working to provide up-to-date guidelines for pregnant women and new parents during the pandemic.
She said Canadian clinicians have taken a different approach to their counterparts in China and the United States when it comes to handling deliveries and post-natal care.
"We have not done what other jurisdictions have done, which is if the mom has COVID, they separate the baby from the mom,'' she said.
Canadian doctors have "erred on the side of bonding is best,'' in part based on lessons from SARS and H1N1, said Money, adding that newborns and mothers with COVID-19 are generally kept together unless the case is more serious.
As long as the new parents don face masks and adhere strictly to an array of precautions, Money said the benefits of allowing contact between a mother and her newborn are high.
The likelihood of transmission through breast milk is next to none, she added.
Money advises mothers with milder illness not to cuddle or sit with their babies when they're not breast feeding and to frequently wash their hands.
"We have not seen a high rate of transmission in that setting. So, super careful close quarters like that seem to be reasonably safe,'' she said.
Previous respiratory viruses like SARS and H1N1 have also offered insight into the effects of COVID-19 on babies in utero, said Money, noting they don't cross the placenta and cause infection for fetuses.
She said research is ongoing, but clinicians believe that's also the case for the novel coronavirus.
"The babies, for the most part, appear to be well,'' she said.
"We are early days and we must add a degree of caution around that until we fully follow those infants out longer term. But generally speaking, we're being very reassuring.''
However, Money said if the expectant mother has a severe case of COVID-19 and ends up in intensive care, that could be problematic for the fetus.