Pregnancy and COVID-19 – Symptoms and Vaccination

Pregnancy may be one of life's greatest joys, one which both mothers- and fathers-to-be relish with excitement and anticipation of baby's arrival.

However, with the COVID-19 pandemic in full swing around the world, this heightened excitement often gives way to anxiety and stress over the many 'What ifs' that could happen.

"Being pregnant, am I at a greater risk of being infected? How will the virus affect my baby? How can I take better care of myself?" Dr John Yam, obstetrician and gynaecologist at Gleneagles Hospital, answers some of these commonly asked questions, from expectant parents worried about the threat COVID-19 poses.

Pregnancy during COVID-19

At present, it is unknown how many pregnant women have been infected with COVID-19 but experts believe the number to be low. Thus far, no deaths have been reported in Singapore amongst expecting mothers who contracted COVID-19 and COVID-19 has not been shown to cause foetal abnormalities.

However, there is data indicating that pregnant women may be more likely to develop severe COVID-19, and face higher risk for maternal and new-born complications hence it is advisable for pregnant women to be vigilant and practice all the recommended COVID-19 preventive measures.

COVID-19 risks while pregnant

Pregnant women will experience changes in their immune system, making them more susceptible to viral infections, such as COVID-19 and influenza. Furthermore, depending on the type of virus, different complications may occur in expecting mothers.

COVID-19 precautions and vaccinations for pregnant women

Women who are pregnant or breastfeeding are eligible to receive the mRNA-based COVID-19 vaccine.

Is it safe for pregnant women to get the COVID-19 vaccine?

Studies on women who were vaccinated while pregnant, reviewed by the Expert Committee on COVID-19 Vaccination, found no evidence to suggest that the mRNA-based Pfizer-BioNTech or Moderna COVID-19 vaccines may cause harm to pregnant women or their babies. To-date, there have been no vaccine-related side effects reported in babies who were breastfed by mothers who were vaccinated while breastfeeding, as mRNA-based vaccines are not live vaccines and unlikely to affect breastfed babies.

Recommended COVID-19 precautions for pregnant women

Apart from vaccination, the recommended COVID-19 precautionary measures should also be practised by pregnant women. The following practices are also applicable to the rest of the population:

• Wash your hands regularly and thoroughly with soap and water, or disinfect your hands with an alcohol-based hand rub with an alcohol content of at least 70%.
• Follow the 20-second rule when cleaning your hands to clear its surface of potential viruses.
• Follow good hygiene practices, such as covering your mouth and nose with your bent elbow or a piece of tissue when you cough or sneeze. This will protect the people around you from viruses such as the common cold, flu and COVID-19. Make sure to dispose the used tissue immediately.
• Stay away from crowded, poorly ventilated places as the chances of spreading virus infections in such places are higher through contact.
• Maintain good social distancing. Follow the current guidelines on maintaining an appropriate distance of 1m or more from anyone, especially if they are showing symptoms such as coughing or sneezing as small liquid droplets from their nose or mouth may contain virus.

Common pregnancy symptoms that may be mistaken as COVID-19 symptoms

Nasal congestion

Nasal congestion can occur in up to 20% of healthy pregnant women. This may be mistaken for COVID-19 symptoms. On the other hand, nasal congestion, if present, may also mask symptoms of a COVID-19 infection. It may also cause sneezing, which could transmit the disease to the people around you.

Shortness of breath

Shortness of breath due to pregnancy is also a fairly common symptom pregnant women experience.

When in doubt, please consult your doctor.

Getting COVID-19 during your pregnancy

If you have any symptoms of a respiratory infection such as fever, cough and/or difficulty in breathing, you should consult your doctor immediately, as a respiratory infection could lead to serious complications, require hospitalisation or affect your baby's health.

If you suspect that you have been exposed to someone with COVID-19, please inform your doctor beforehand for advice on what to do next.

Does COVID-19 transmit to the baby?

There have been very few cases of pregnant women being infected with COVID-19, so our understanding of this is still evolving. However with the few cases of infection, babies were not severely affected after being born to mothers who had tested positive for COVID-19.

Breastfeeding during COVID-19

Based on our current knowledge about the virus, breastfeeding can continue even if a mother tests positive for COVID-19.

However, wear a face mask when you are carrying your child and observe strict hygiene to reduce the risk of droplets from your mouth and nose coming into contact with your baby.

Keeping your child safe during COVID-19

Are babies at a higher risk of contracting COVID-19?

They appear to have equal risk as adults contracting the virus. However, with the current state of knowledge, the risk of severe complications seems to be much lower in babies than that of adults.

What are some precautions I can take to keep my newborn safe from COVID-19 and other respiratory conditions?

Observe strict personal hygiene to reduce the risk of droplets from your mouth and nose from coming into contact with your baby. Alternatively, keep newborn or young children at home and practise responsible social distancing until the situation improves.

How do I ensure a safe environment for my child at home and in public?

Practise strict personal hygiene, wear a mask and maintain social distancing. Ensure that all objects and surfaces that your child comes into contact with are meticulously kept clean, and washed thoroughly with soap and water.

If you suspect you have been exposed to COVID-19, you are advised to conduct your own Antigen Rapid Test (ART) at home. If the results are positive, you should take a PCR test to confirm the results. However, should you experience any COVID-19 symptoms, such as fever, cough, runny nose or loss of taste or smell, you should see a doctor to get tested for COVID-19.