The Management of Covid-19 Infection in Pregnancy and Puerperium: From the World View to the Italian Reality

Abstract

Coronavirus disease 2019 (Covid-19) is characterized by severe acute respiratory syndrome and is an emerging disease. Considering the changes in maternal physiological and immune function during pregnancy, pregnant women may be at increased risk of being infected with Covid-19 and developing more complicated clinical events. Vertical transmission of the Covid-19 virus is possible although to this day it is still considered a rare event. It is conceivable that most pregnant patients infected with the Covid-19 virus have mild or moderate flu symptoms. More serious symptoms, such as pneumonia, in fact, seem to be more common in the elderly population or in subjects suffering from chronic diseases. As a precaution, pregnant women are considered the most vulnerable and therefore isolation and limitation of contact are recommended. At the moment there are no data to indicate whether spontaneous delivery is preferable in case of coronavirus infection (suspected or confirmed) to a cesarean section. However, in case of breathing difficulties that require delivery as soon as possible, a cesarean section is recommended. There is no evidence that the virus can be transmitted through breast milk. Furthermore, breastfeeding is preferable and has numerous benefits for the newborn's immune system. Since pregnant people appear to have a high risk of becoming seriously ill if they have an infection, vaccination is particularly important. In addition, there is evidence that vaccinated people have a lower risk of baby problems, such as stillbirth.

COVID-19 Vaccine Acceptance of Pregnant Women in Thailand

“…There are no known or theoretical risks of vaccination when it comes to vaccinating lactating people. 26 Positive factors influencing COVID-19 vaccine acceptance included the desire to prevent infection and reduce disease severity, followed by the motivation to protect their babies. On the other hand, vaccine hesitancy was primarily driven by concerns about vaccine safety during pregnancy and its potential harm to babies, followed by personal vaccine safety concerns.…”

“…There are no known or theoretical risks of vaccination when it comes to vaccinating lactating people. 26 …”