COVID-19 in pregnant women – Authors' reply
David Baud
Eric Giannoni
Léo Pomar
Xiaolong Qi
Karin Nielsen-Saines
Didier Musso
et al.
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Published:March 17, 2020DOI:https://doi.org/10.1016/S1473-3099(20)30192-4
We are grateful for the concerns of Manuel Schmidt and colleagues about our previous guidelines1 for pregnant women with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. At the time we developed the algorithm (February, 2020), there were no data regarding potential vertical transmission from infected mothers and outcomes in newborns. To date, there has been no evidence of vertical transmission of coronavirus disease 2019 (COVID-19) based on two small clinical series.2, 3 According to WHO, delayed umbilical cord clamping is highly unlikely to increase the risk of transmitting pathogens from the mother to the fetus even in the case of maternal infection.4 Because the vernix caseosa contains antimicrobial peptides, we recommend leaving it in place until 24 h after birth.5 New data examining neonates from infected mothers could be reassuring, but transmission after birth via contact with infectious respiratory secretions is still a concern, and physical separation of mother from child should be considered. Separation is a standard practice in pulmonary tuberculosis and is discussed in cases of maternal influenza infection.6 Therefore, separation of the mother and her newborn baby should be individually discussed by an interdisciplinary team, considering local facilities and risk factors for adverse neonatal outcomes, such as prematurity and fetal distress.
