Viral Shedding of COVID-19 in Pregnant Women

Abstract

Background: Since there is little awareness of the consequences of coronavirus disease 2019 (COVID-19) in pregnancy, data on the safety of vaginal delivery and breastfeeding in pregnant women with COVID-19 are urgently needed.

Methods: We studied COVID-19- infected pregnant women diagnosed at the Renmin Hospital of Wuhan University between January 31 and March 9, 2020, and collected clinical data, vaginal secretion, and stool specimens during different stages of pregnancy. We also collected breast milk samples, as well as throat and anal swabs from the corresponding infants to detect the presence of the virus.

Results: Of the 13 women with COVID-19, 5 were in their first trimester, 3 in their second trimester, and 5 in their third trimester. Clinical manifestations observed among the 13 women included fever (n = 8), cough (n = 5), increased leukocyte count (n = 3), lymphopenia (n = 2), impaired liver function (n = 3), dyspnea (n = 1), myalgia (n = 1), and diarrhea (n = 1). Of the 5 women during their third trimester who gave birth, all delivered live newborns. Among these 5 deliveries, the primary adverse perinatal outcomes included premature delivery (n = 2) and neonatal pneumonia (n = 2). One of the 5 women followed from the first trimester experienced a biochemical pregnancy. One of 9 stool samples was positive; and all 13 vaginal secretion samples, and 5 throat swabs and 4 anal swabs collected from newborns were negative for the novel coronavirus. However, 1 of 3 samples of breast milk was positive by viral nucleic acid testing.

Conclusions: In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination.

Note: Funding: This work was supported by the National Key Research and Development Program of China (2018YFC1002804, 2016YFC1000203).

Conflict of Interest: Ben W. Mol is supported by a NHMRC Investigator grant (GNT1176437). BWM reports consultancies for ObsEva, Merck KGaA, iGenomix, and Guerbet, with no potential conflicts of interest.

Ethical Approval: This study was approved by the Medical Ethical Committee of Renmin Hospital of Wuhan University (No. WDRY2020-K097), Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science &Technology (No. WHCH 2020014), and the Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University (No. GKLW2020-05).

Keywords: COVID-19, breast milk, vaginal secretions, pregnant women