As medical experts and researchers around the world race to gain a better understanding of how the novel coronavirus is threatening our health and way of life, there is one area of study that could have very real implications for the generations of tomorrow: pregnancy.
The impact of COVID-19 on pregnancies remains an under-researched topic, leading many expecting mothers to take extra precautions amid the uncertainty surrounding their health and the wellbeing of their child.
“There's just a lot more caution that's required,” said Kyra Woodward, 33, who is five months pregnant. “Pregnancy is always a time of uncertainty, and there’s certainly more of it right now.”
Worry Over Medical Complications
Last year, her first son, Jude, was placed in a neonatal intensive care unit for 10 days as the result of unforeseen medical complications. Now, Woodward worries whether the coronavirus will impact her second pregnancy.
“We are acutely aware of how quickly everything can turn, and how scary it is having a newborn that has life-threatening complications,” she said. “We've just been super, super careful.
Kyra and her husband are now taking extra precautions when dealing with the outside world: non-perishable groceries are kept in the car for up to 48 hours, and perishable items are scrubbed with alcohol before they are put away. Kyra now travels everywhere with a mask, avoids using public restrooms, and keeps outside trips with her son to a minimum.
“We’re exercising so much caution because we don’t know what the right protocols are,” she said. “What I'm really hoping is that we understand more about how this affects pregnant women, how it affects babies.”
New Nationwide Study to Explore Impact of Coronavirus on Pregnancy
A new joint study between the University of California, San Francisco and the University of California, Los Angeles aims to address some of those questions by tracking the health of at least 1,000 pregnant women who have contracted the virus or are awaiting testing. The study, known as the Pregnancy Coronavirus Outcomes Registry, or PRIORITY, is nation-wide, and already enrolled at least 500 women.
Dr. Stephanie Gaw is an assistant professor of maternal-fetal medicine at University of California, San Francisco.
“We know very little at this point,” said Dr. Stephanie Gaw, a co-investigator on the PRIORITY study who specializes in high-risk pregnancies. “The data is very spotty and not completely comprehensive in capturing the full potential spectrum of disease in pregnancy.”
The urgency to fill that gap in knowledge, Gaw said, is driven by the fact that, to date, there are only a handful of studies on the issue, mainly from China, which Gaw describes as inconclusive and limited in scope.
While pregnant women have been considered a high-risk group for other respiratory illnesses, such as SARS and H1N1, their risks with the coronavirus remain unclear. By getting a better grasp on the virus’ impacts, Gaw and her colleagues hope their findings can improve medical care for new and expecting mothers.
It’s one half of a two-part equation, though.
On the other end is the health of the newborn – another inconclusive area of study – and one that Dr. Valerie Flaherman, a pediatrician at UCSF Medical Center and co-investigator of the PRIORITY Study, hopes to examine further.
“Pregnant women and newborns are in a vulnerable phase of life and are at a risk for more serious consequences from infection than people in other life stages with the COVID pandemic,” she said, adding that she hopes by understanding the consequences and predictors of infection, the team will be able to identify best practices, both pre and post birth, for newborns.
There is a potential twist, though, Flaherman noted. Even though newborns have immune systems comparable to those of older adults considered at high-risk, the limited research already published suggests that they do not experience such adverse outcomes. To put it another way: the underdeveloped immune system that puts babies at a higher risk for contracting other illnesses may, somehow, be shielding them, partially, from COVID-19.
Pediatrician Dr. Valerie Flaherman is an associate professor of pediatrics as well as epidemiology and biostatistics at the University of California, San Francisco.
Hospitals Institute Restrictions to Protect Pregnant Women and Babies
In the wake of so much uncertainty, hospitals across the country are implementing heightened restrictions to protect the health of mothers and their children. The Investigative Unit reached out to five of the largest hospitals in the Bay Area to understand the extent of the measures being instituted. All five, including Kaiser Permanente, Sutter Health, UCSF, Stanford, and San Jose Regional Medical Center have limited visitor access and will only allow one support person to join mothers in the delivery room.
But until that day comes, and more information is known about exactly how COVID-19 can impact pregnant women and their children, Woodward and her husband are already talking about backup plans, like ordering additional adaptors and charging cables so she can share the birth remotely, if her husband cannot be there in person.
“That’s a choice we’re willing to make,” she said. “And it’s a serious one because it’s not anywhere close to what we envisioned.”