Pregnancy and COVID-19

Updated 11 October 2021

Author: Dr Andrew Dickson, Occupational Health Physician

The following is a precis of the principal findings and recommendations published by the Royal College of Obstetricians and Gyneacologists on 19 July 2020. The full advice – with considerably more detail and answers to most common questions can be found at: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/#pregnancy

• Pregnant women are no more likely to contract COVID-19 than other healthy adults, but they are at slightly increased risk of becoming severely unwell if they do catch COVID-19, and are more likely to have pregnancy complications, including preterm birth and stillbirth.
• Roughly two-thirds of pregnant women with COVID-19 have no symptoms and the majority with symptoms have only mild cold or flu-like symptoms.
• Pregnant women who contract COVID-19 are at slightly increased risk of becoming severely unwell compared to non-pregnant women, particularly in the third trimester.
• Vaccination is recommended in pregnancy.
• Pregnant women who are unvaccinated or not fully vaccinated may choose to limit the close contact they have with those they do not usually meet with in order to reduce the risk of catching or spreading COVID-19, particularly if they are in the third trimester and when COVID-19 disease levels are high in their community.
• It is unclear whether pregnancy alters the proportion of women who develop ‘Long COVID’ or other post-COVID-19 conditions.
• Pregnant women from Black, Asian and minority ethnic backgrounds are more likely than others to be admitted to hospital for COVID-19.
• Pregnant women over the age of 35, those who have a BMI of 25 or more, and those who have pre-existing medical problems, such as high blood pressure and diabetes are at higher risk of developing severe illness and requiring hospital admission.
• Living in areas or households of increased socioeconomic deprivation is also known to increase the risk of developing severe illness.
• Current evidence suggests maternal infection with COVID-19 is unlikely to lead to lead to developmental problems in the baby.

Coronavirus, pregnancy and employment.

• A workplace risk assessment must be carried out (as for any pregnant worker).
• Significant risks must be removed or effectively managed. If this cannot be achieved suitable alternative work or working arrangements must be offered (including working from home) or the individual must be suspended on pay.
• Employers must ensure staff are able to adhere to any active national guidance on social distancing.
• This advice must be adhered to even more strictly after 28 weeks gestation.
• ‘Occupational health guidance for pregnant women who work in a public-facing role’ can be found at the end of the RCOG document.
• Further advice is given in government guides for different industries (reviewed 30 September 2021).