Understanding Implications for Fetal, Neonatal and Maternal Health during the COVID-19 Pandemic

Dr. Rosemary Higgins of Mason CHHS and Dr. Uma M. Reddy of the Yale School of Medicine discussed the ways COVID-19 has changed prenatal and neonatal healthcare and the research still required.

In the first of the College’s COVID-19 Webinar SeriesDr. Rosemary Higgins and Dr. Uma Reddy discussed the short and long-term implications of COVID-19 and health care practices for pregnant women and neonates. More than 70 attendees participated in the event.

“We’ve heard a lot about the elderly and individuals with immune compromised status being at high risk for COVID infection, for hospitalization and even death,” said Dr. Germaine Louis, dean of the College, who moderated the panel on May 18. “However there are other subgroups of our population who are also at risk such as pregnant women.”

Higgins is the associate dean for research in the College; she is a neonatologist whose research focuses on neonatal and perinatal medicine, childhood outcomes and longitudinal follow up of clinical trials and observational studies. Reddy is a professor of obstetrics, gynecology, and reproductive sciences. She is also a practicing clinician and the division director of maternal-fetal medicine at the Yale School of Medicine. 

During the panel, Reddy discussed how health care practices for pregnant women have changed during this time. First, they began screening women for symptoms prior to their appointments. Additionally, her clinic was able to safely reduce in-person visits through telehealth practices. She also expressed the importance of both health care providers and patients wearing masks at the clinic. At Reddy’s practice, pregnant women exposed to COVID-19 receive close follow-up every 48 to 72 hours through telehealth calls.

“We want to guarantee the same experience despite it being in the time of COVID,” said Reddy on COVID-19 patients giving birth at the hospital. Balancing the experience of support during the labor and delivery while preventing unnecessary exposure is a priority. 

Higgins spoke about newborn care for women with COVID-19. “If the mothers are COVID positive, they can see their babies as long as they have a mask on,” she explained on delivery room care, but also noted that the American Academy of Pediatrics recommends separating infants from mothers that are positive for the virus. Breastfeeding is still possible if a mother can wear a face mask during feeding or can express milk to be fed to the infant. 

Many case reports have shown that babies born to mothers with COVID-19 test negative, according to Higgins. However other case reports in China and Italy have demonstrated differently. Overall, more research is needed to understand whether infection through the birth canal is a possibility for pregnant women with the virus as well as other questions on pregnant women and infants with COVID-19. 

Both Higgins and Reddy also answered questions from participants during the webinar. Reddy explained that pregnant women are not more likely to be infected and that everyone is at risk. She also mentioned that pregnant women should not be afraid to do daily, essential activities as long as they wear masks, practice social distancing and wash their hands. 

Both panelists mentioned that the racial, ethnic and geographic disparities among pregnant women with COVID-19 are concerning and follow the same trends for all infections. 

“I’m quite sure that we’re going to be able to manage this current pandemic,” affirmed Dean Louis, who also thanked Higgins and Reddy for their participation in the college’s COVID-19 webinar series. “Clinicians and public health folks working together will be able to bring guidance so we can ensure the well-being of pregnant women, their fetuses and neonates.” 

Details for upcoming webinars and recordings of previous webinars can be found on the CHHS COVID-19 Webinar Series page.