COVID-19: what you need to know about coronavirus and pregnancy

Why has the government put pregnant women in a high-risk group?

Our knowledge about this form of coronavirus, which can lead to COVID-19 infection, is still in its infancy. This is true for la gravidanza as for every other aspect of the condition. But we're learning more about it all the time, and for the most part, the news is reassuring for mothers-to-be.

However, we do know that pregnancy has an effect on your immune system. There's no question that for some other infectious diseases, women who are pregnant have a higher risk of complications. It's for this reason - as a precaution - that the government has recommended that pregnant women should take the same measures as other people at rischio maggiore of severe complications from coronavirus.

Currently, the government recommends that everyone should be practising distanziamento sociale. However, it's highly likely that in the next week or two they will be recommending that people in high-risk groups should take steps to auto-isolarti to protect themselves.

Il NHS has issued guidance to all its organisations to allow pregnant women to work remotely if possible, or to move to working in a lower-risk area.

The main symptoms of coronavirus are fever (temperature about 37.8°C) and a new persistent cough that lasts at least half a day. If your symptoms are mild, use the Patient Access Coronavirus checker tool to find out what steps you and your family should take. If your symptoms get worse, you should contact NHS 111 or your maternity team immediately for advice.

You'll almost certainly need to put off any routine antenatal appointments - please contact your maternity team to inform them, so they can make other arrangements.

If you're close to your due date, you should let your maternity team know as they will need to make special arrangements if you go into labour.

NHS hospitals are under increasing pressure because of patients being admitted with severe illness due to coronavirus.

Doctors took steps early to examine any possible link between pregnancy and higher mortality from COVID-19. Their concern arose from previous experience, which showed that pregnant women who catch l'influenza have a higher risk of serious complications and death - in fact, before the introduction of free NHS flu vaccination for all pregnant women, in 1 in 11 UK women who died during pregnancy, flu was the cause.

Reassuringly, the evidence thus far suggests that pregnancy alone does not increase the risk of severe complications of COVID-19. The large majority of pregnant women who do become infected will have only mild or moderate symptoms and will not need hospital admission.

However, it is important to bear in mind that many conditions put you at increased risk of serious complications of coronavirus infection. They include asthma or other long-term lung disease; diabetes; kidney problems; long-term neurological conditions such as multiple sclerosis; cancer and chemotherapy. Having any one of these conditions when you are pregnant does make you more vulnerable to severe illness.

There is currently no evidence that coronavirus infection in pregnancy increases your risk of aborto spontaneo or losing your baby in the early stages of pregnancy. To date, there is prove that COVID-19 infection can be passed to your baby through the placenta during pregnancy.

The answer to this is complicated. There is some evidence that women with coronavirus in China were more likely to give birth prematurely. However, we don't know about 'cause and effect'.

It's possible that their doctors made a decision to induce labour early because they were worried about the well-being of mother and baby. There has been one case where a mum went into labour prematurely, but we don't know whether that would have happened anyway. So having coronavirus per se may or may not increase the chance of premature birth.

Whatever happens, if you do give birth while you're infected, your team will be taking extra precautions to ensure your baby's well-being.

'Vertical transmission' of an infection occurs when infection is passed from a mother to her unborn baby through the placenta. To date, several studies have been carried out, and until March 26th 2020, they all suggested no evidence of vertical transmission. This fitted with the fact that in two previous epidemics due to coronaviruses which caused illness in humans, SARS and MERS, there were no confirmed cases of vertical transmission either.

However, a new report has found a single case where a baby whose mother had the infection was found to have antibodies to coronavirus at birth. It's just one case so far but the overall numbers are very small, so your team will definitely be monitoring your baby very carefully if you do have coronavirus during pregnancy.

At the moment, unless you or your partner have symptoms of possible coronavirus infection, your partner should be able to stay with you during labour and the birth of your baby (unless you need a general anaesthetic).

Because of possible pressure on emergency ambulances if there is a problem during home birth, and the pressure on maternity services, some hospital trusts have suspended home births.

Individual hospitals may have their own restrictions on whether you can have more than one birth partner, whether you're allowed visitors in the antenatal or postnatal wards and whether you can swap visitors after delivery.

But it is important to remember that this is a very fast moving situation, so the guidance may change.

Unless you're infected, it's always best to allatti al seno. Breastfeeding provides your baby with a host of benefits, including immunity passed from you to a host of infections.

Thus far, there is prove that coronavirus infection is passed to babies through breast milk. However, not that many women have been tested yet, so we can't be 100% certain. We do know that because newborn babies are in close contact with their mothers, your baby will be at higher risk of catching the infection from you in the days after delivery.

Il Collegio Reale degli Ostetrici e Ginecologi (RCOG) has produced guidance on steps to take to reduce the risk to your baby if you have coronavirus when you deliver. They include:

This article was updated on 30th March following a change in RCOG guidance.