Transmission of the coronavirus from mother to baby before birth, during possible delivery: ICMR

NEW DELHI: The Indian Council of Medical Research said Monday that emerging evidence suggests that transmission from mother to baby before birth or during delivery is possible, although the proportion of affected pregnancies and the importance to the newborn have not yet been have been determined.

The Apex Health Research Agency also said that there are no recorded cases of positive breast milk results at this time, and that there is no data to suggest an increased risk of miscarriage or early pregnancy loss related to the disease.

... Emerging evidence now suggests that vertical transmission (from mother to prenatal or intrapartum baby) is likely, although the proportion of affected pregnancies and importance to the newborn has not yet been determined, he said.

However, it is unknown whether newborns with Covid-19 are at increased risk for serious complications, and transmission after birth through contact with infectious respiratory secretions is a concern, he said.

In a guide to managing pregnant women during the pandemic, the lead agency said hospitals should consider temporary separation. (separate rooms) the mother, who has COVID-19 or is a suspected case, from her baby until precautions based on mother's transmission are suspended.

Also, there is currently no evidence that the virus is teratogenic (which causes developmental malformations). Long-term data is expected, the ICMR said.

He clarified that pregnant women do not seem to be more likely to contract the infection than the general population. However, pregnancy itself impairs the body's immune system and response to viral infections in general, which can sometimes be related to more severe symptoms and this will be the same for Covid-19.

In other types of coronavirus infection (SARS, MERS), the risks to the mother appear to increase, particularly during the last trimester of pregnancy. There are reports of cases of preterm delivery in women with Covid-19, but it is unclear whether preterm delivery was always iatrogenic or whether some were spontaneous.

Pregnant women with heart disease are at the highest risk (congenital or acquired), the ICMR said, adding that the coronavirus epidemic increases the risk of anxiety and perinatal depression, as well as domestic violence.

It is vitally important that support for women and families be strengthened as much as possible; women to be asked about mental health at each contact, she said.

The guideline states that obstetric units must ensure adequate isolation of pregnant patients who have confirmed Covid-19 or are under investigation.

Healthcare providers must create a plan to address the potential for a decline in the workforce, the potential shortage of personal protective equipment, limited isolation rooms, and must maximize the use of telemedicine for antenatal care.

ICMR said the guide is based on the limited evidence available to date on transmission of the virus that causes Covid-19, and knowledge of other viruses that cause severe respiratory illness, including influenza, severe acute respiratory syndrome coronavirus (SARS- CoV) and Middle Coronavirus Eastern Respiratory Syndrome (MERSCoV).

The recommendations are based on guidelines from international disease control agencies and publications and were simplified for the Indian context, according to the document.