Babies born by C-section are LESS likely to catch coronavirus from an infected mother as scientists find the disease is NOT passed on in the womb
- 12 babies born in Wuhan to mothers with COVID-19 didn’t show signs of infection
- Another baby born via a natural delivery also did not show COVID-19 symptoms
- The team say vaginal delivery may be safe although the area needs further study
- Coronavirus symptoms: what are they and should you see a doctor?
Coronavirus is not transmitted from mothers to their newborn babies if they give birth by cesarean section, a Chinese study suggests.
Babies born by C-section – an operation that cuts a hole in the womb to deliver the baby – may be less likely to catch coronavirus from an infected mother.
12 infants born by C-section in Wuhan, the epicentre of the outbreak, had no symptoms of COVID-19 despite all being born to infected mothers, scientists found.
It’s known babies can be exposed to viruses in the vaginal canal and C-sections could reduce the risk.
One child observed during the study that was born through a vaginal delivery also showed no signs of illness.
The study follows a baby in London being born with COVID-19 – the youngest case in the UK, although it’s unknown how the baby was born.
A study of 13 babies born to mothers with coronavirus – 12 of which born by C-section – found none developed symptoms of COVID-19 and remian healthy
‘To avoid infections caused by perinatal and postnatal transmission, our obstetricians think that C-section may be safer,’ said Dr Yalan Liu of Huazhong University.
WHAT ARE THE MEDICAL REASONS FOR A CAESAREAN?
There are various reasons why a doctor may recommend that you have a caesarean section instead of giving birth vaginally.
If you had complications in a previous pregnancy or birth, or in your current pregnancy, you may be advised to have what’s called a planned or elective caesarean, or a planned repeat caesarean.
If you were planning to give birth vaginally, but complications during labour or birth mean that you’re advised to give birth by caesarean, you’ll have what’s called an unplanned or emergency caesarean.
Here are some reasons why doctors may opt for a planned or emergency caesarean, rather than a vaginal birth:
- You’ve already had at least one caesarean section.
- Your baby is in a bottom-down, or breech, position.
- Your baby is in a sideways (transverse) position, or keeps changing its position (unstable lie).
- You have a low-lying placenta (placenta praevia).
- You have a medical condition, such as heart disease or diabetes.
- You have lost a baby in the past, either before or during labour.
- You’re expecting twins or more.
- Your baby is not growing as well as it should be in your womb.
- You have severe pre-eclampsia or eclampsia, making it dangerous to delay the birth.
Source: BabyCentre
‘Only one pregnant mother adopted vaginal delivery because of the onset of the labour process.
‘The baby was normal. Maybe vaginal delivery is OK. It needs further study.’
The Chinese study of 13 babies and their mothers in total is based on two separate investigations.
The latest involved four babies at Union Hospital, Wuhan, where Dr Liu is a paediatrician – only one of which was born to a mother who opted for a vaginal delivery.
All four were initially isolated in neonatal intensive care units and fed formula milk, and none went on to develop any serious symptoms such as fever or cough, which are common symptoms of the illness.
Three of the four tested negative for the respiratory infection following a throat swab, although the fourth child’s mother declined permission for the test.
One experienced a minor breathing issue for three days that was treated by a non-invasive mechanical ventilation.
Two babies, including the one with a respiratory problem, did have body rashes that eventually disappeared on their own.
The researchers say it’s impossible to conclude whether there’s a connection between these other medical issues and COVID-19.
‘We are not sure the rash was due to the mother’s COVID-19 infection,” said study co-author Dr Yalan Liu at Huazhong University of Science and Technology.
All four infants are healthy and their mothers have also fully recovered, the team report in the journal Frontiers in Pediatrics.
The second part of the study, conducted at nearby Zhongnan Hospital last month, included nine infants – all born by C-sections.
The scientists found these mothers with COVID-19 during pregnancy did not infect their babies.
Further investigations into other aspects of potential COVID-19 infection in newborns and children are needed, said Dr Liu.
A newborn baby infected with coronavirus is being treated at North Middlesex Hospital where it was born, while the mother was moved to a specialist infections hospital
For example, the sensitivity of the current diagnostic test for detecting the virus is about 71 percent.
The researchers are collecting additional fluid samples from newborns, including from the placenta, to improve accuracy in children.
The deadly illness has now spread to more than 100 countries, killing over 5,000 people and making more than 135,000 sick.
Around 140 million babies are born globally each year and there have been concerns COVID-19 could be passed on in the womb, just like the Zika virus.
Zika virus led to reports of pregnant women giving birth to babies with birth defects, including the head shrinking condition microcephaly.
Britain has one of the highest rates of caesarean section in Western Europe, with more than a quarter of babies now born this way – nearly half by choice.
A baby born at North Middlesex Hospital in Enfield had COVID-19, it was reported on Saturday.
The infant’s mother had been taken there with suspected pneumonia.
After the birth both tested positive for the virus, although the mode of delivery has not been revealed.
It’s not known whether the child contracted the disease in the womb or was infected during birth.
Up to 100 million Europeans are on lockdown as the coronavirus total infections for the continent reaches 57,000
Coronaviruses are a large family of viruses that infect birds and mammals, including humans.
They range from the common cold to more serious respiratory infections such as SARS and MERS.
Pregnant women with SARS and MERS have become critically ill, suffered miscarriages and even died.
Globally, an estimated 3.4 percent of reported COVID-19 cases have died, according to the latest data from the World Health Organisation.
In comparison, seasonal flu generally kills far less than 1 per cent of those infected, but COVID-19 does not appear to spread as easily.
WHAT DO WE KNOW ABOUT THE CORONAVIRUS?
What is the coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.
Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.
The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Where does the virus come from?
According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.
However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
What does the virus do to you? What are the symptoms?
Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.
However, an investigation into government surveillance in China said it had found no reason to believe this was true.
Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.
Can the virus be cured?
The COVID-19 virus cannot be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.
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