(Reuters) - After the first two cases of the novel coronavirus in the state of Georgia were confirmed this week, Leigh Creel, who is 20 weeks pregnant and lives outside Atlanta, made a nervous phone call to her doctor to ask about the risk to her and her fetus.
The response she got was not comforting. Health experts do not know if pregnant women are more susceptible to the virus or if contracting it will increase the likelihood of adverse pregnancy outcomes, such as pre-term labor or transmission of the virus in utero.
They are racing to learn more about the sometimes fatal respiratory disease that has rapidly spread worldwide from China, including how it might uniquely affect pregnant women.
For expectant mothers, the mystery surrounding the virus is worrying.
“It’s concerning to me when I feel like I know as much as the healthcare professionals,” said Creel, who works in sales and lives with her husband and toddler.
The U.S. death toll from COVID-19 now stands at 14, most of them in Washington state, where 12 people have died in a cluster of at least 50 infections in the Seattle area. More than 3,400 people have died worldwide.
Public health officials in Washington’s Seattle and King Counties have advised that people at “higher risk of severe illness,” including pregnant women, should avoid physical contact and going out in public.
Dr. Laura Sienas, an obstetrician-gynecologist at the University of Washington Medical Center, said most of her pregnant patients have asked what they can do to protect themselves.
Sienas said her hospital has stopped short of urging pregnant women to quarantine themselves, contrary to local public health official guidelines.
Instead, she has emphasized diligent hygiene and avoiding close contact with others, the same guidance the U.S. Centers for Disease Control has offered on its website.
To that end, Sienas has tried to arrange check-ups via telephone, aiming to limit the number of in-person visits pregnant patients make to the hospital.
“There’s definitely that fear of the unknown, and pregnancy is a time when there are a lot of things that you don’t know and can’t control,” Sienas told Reuters. “Trying to give people small steps that they are able to control, like handwashing, has been a bit reassuring to patients.”
Scientists have not yet developed a vaccine against the virus, and research on its transmission and effects on pregnant women has been limited.
A narrow study of nine coronavirus-positive pregnant women in the Wuhan region of China, all in their third trimester, found no evidence that COVID-19 was transferred in utero. The women showed symptoms similar to non-pregnant adult patients.
The World Health Organization published an analysis of 147 pregnant women (64 of whom were confirmed to have COVID-19, 82 who were suspected and 1 who was asymptomatic) and found that 8% had a severe condition and 1% were critically ill.
“There’s some suggestion from other coronaviruses such as SARS that pregnant women may have a more severe disease, but we really don’t know,” said Dr. Denise Jamieson, chief of gynecology and obstetrics at Emory Healthcare in Atlanta and a former epidemic intelligence officer at the CDC.
Normal immunologic and physiologic changes in pregnant women might make them more susceptible to viral infections, including COVID-19, according to the CDC.
“There doesn’t seem to be any great answers out there for anyone, so your mind can really run wild with the possibilities,” said Rachel Storniolo, 36, who lives in Philadelphia and is due to give birth in May.
The study of the Chinese women, published in the scientific magazine The Lancet, found no traces of the virus in breast milk. Still, Jamieson said she would warn coronavirus-positive mothers that they risk transmitting the virus to their infants through respiratory droplets if they choose to breastfeed.
“If a woman has confirmed coronavirus, the safest thing in terms of ensuring that the infant does not get infected from the mother is to separate the mom and baby,” she said, adding that separation might be necessary for several days until the mother is asymptomatic.
Officials have not reported any cases of pregnant women with coronavirus in the United States, and they believe pregnant women - and the rest of the general public - who live outside the outbreak areas are at low risk.
But some women, like Brandi Cornelius, 36, of Portland, Oregon, who is 23 weeks pregnant, are not taking any chances.
“I went to the bank and I used hand sanitizer three times while I was there,” she said. “It helps my body to go to prenatal yoga, for example, but do I want to be in a room full of people?”
Reporting by Gabriella Borter in New York; Editing by Frank McGurty and Dan Grebler