Researching COVID-Pregnancy-Infant Transmission

"There are questions, there is uncertainty and there are so many more tears It has never been harder for me to give care."
"I want to do one clinic without making people cry someday soon."
"The patients have all these questions. We need to be able to answer them and to understand what this could mean to help with delivery planning."
"There is so much anxiety about getting it [COVID-19],and taking care of their baby."
Dr.Darine El-Chaar, maternal-fetal medicine physician, The Ottawa Hospital

In this photo, a doctor performs an ultrasound scan on a pregnant woman at a hospital. Clinicians and epidemiologists don't yet know much about COVID-19 and pregnancy, says the leader of a newly formed national network that's aiming to fill in those gaps. THE CANADIAN PRESS/AP-Teresa Crawford

Dr. El-Chaar is also a researcher at The Ottawa Hospital Research Institute. Funding has been received from the Canadian Institutes of Health Research for COVID-19 for her research team looking to find answers to questions about COVID-19 and pregnancy. One of the vital questions this team seeks to find an answer to is whether a mother can pass COVID-19 to her baby.

To that end, the team plans to investigate whether a mother can infect her child with the virus during pregnancy. The research is the first such to be undertaken in Canada. Studies have been produced by some researchers globally but there is much that is not yet known about COVID-19 and how it affects pregnancy, that of both mother and child.

According to results of early research, up to 80 percent of pregnant women infected with COVID-19 experience fairly mild symptoms of the disease, while between 15 and 20 percent of women experience moderate or severe symptoms. Unclear as yet is how many pregnant women tested positive so far for COVID-19 in Ontario. What is known is that over fifty hospitals in the province have reported such cases.

Most pregnant patients have experienced moderate or mild symptoms, and to the present no local cases of COVID transmission from mother to baby have been identified. Out of a total of $4.7 million in research funding, a number of studies are being undertaken in the hope of discovering new data about COVID-19. One study is to determine the rate of COVID-19 infection in pregnant women, and to that end every woman giving birth at The Ottawa Hospital will be tested for the virus.

That data will be useful to inform whether universal testing should be undertaken on pregnant women. By testing maternal and newborn samples from participating hospitals across Ontario, another study plans to examine whether a mother is able to communicate COVID-19 to her child during pregnancy. Mothers and babies with a history of infection will provide additional data to be collected.

The research results are expected to provide more expansive clarity on such questions as whether vaginal births and breast feeding could pose an increased risk with COVID-19, or whether mothers who are infected may confer immunity on their infants. Some of the questions that mothers pose associated with concerns about pregnancy during the pandemic may find their answers from this research.

According to Dr. El-Chaar, mothers not infected are also anxious; attributable party to isolation during the pandemic; less face-to-face doctor appointments; having to attend some appointments unaccompanied; and general concerns about the unknown elements clinging to the global pandemic and how expectant women are affected.

Other research taking place at The Ottawa Hospital and funded through the same source along with other agencies, will investigate the potential of harnessing cancer-fighting vaccine sin the development of  a COVID vaccine; whether stem cell therapy can reduce damage from overactive immune responses to COVID-19 in critically ill patients; and research into how the most vulnerable are being affected by the SARS-CoV-2 virus.

•  Pregnancy does not appear to increase a person’s risk of becoming infected with COVID-19.
• Clinical signs and symptoms of a COVID-19 infection are usually the same in pregnant and non-pregnant people, which can include fever, cough, shortness of breath, body aches, fatigue and sore throat.

• The majority of pregnant people in Ontario are healthy and considered low-risk, with no pre-existing health conditions. Healthy pregnant people infected with COVID-19 usually have mild symptoms and recover at home without needing hospital care.

• Experts are not sure yet, but it seems that during pregnancy and birth the risk of transmission is low from a COVID-19 infected mother to their baby. After birth, the COVID-19 infected mother could pass the virus to the newborn if infection control measures are not taken, but the risk of transmission is unknown at this time.

• Most babies born to COVID-19 infected mothers are usually healthy and do not require hospitalization, but some may be born too early or too small and might need longer hospital stays.

BORN Ontario