Penelope Canonico
04/12/2021 10:21
Clarín.com
Society
Updated 04/12/2021 10:21
In the last week of pregnancy, the nutritionist
Fiorella Vitelli
caught Covid-19.
As a matter of protocol, she knew that her husband would not be able to accompany her if the delivery began before receiving the epidemiological discharge.
Fortunately, he obtained it a few hours earlier and Rio was born in the Austral Hospital on April 7, naturally, around 7:00 p.m., weighing 3 and a half kilos.
The symptoms had started on Sunday the 28th. “They were mild and diffuse, I
confused them with labor
.
I thought they were contractions because my lower back hurt and I was extremely tired.
By Tuesday he had a cold.
I lost my smell and appetite a bit.
I had to make an effort to eat for the baby ”, he tells
Clarín
.
He never had fever lines.
They just swabbed her when her partner had severe pain behind her eyes.
With a positive result, Fiorella isolated himself in his room and avoided any search for information on the Internet.
“I felt that finding out more was going to work against me emotionally.
They always told me that the baby was not at risk
.
I stayed with that to keep calm, ”he recalls and points out that since he could not have a chest x-ray or lung tomography, he bought a saturometer to be able to measure oxygen in his blood.
Pregnant and coronavirus.
Fiorella Vitelli and Gabriela Mandato.
“The virus made it difficult for me to breathe well, at times, and emotionally due to the uncertainty of knowing whether or not the protocols would have to be activated on the day of birth.
With Rio's father we prepared a lot to go through it together.
I feel like a bulldozer ran over me
.
Surely, let's do the antibody tests ”, she underlines with today's relief and the joy of being able to breastfeed her first child.
The experience that former dancer
Gabriela Mandato
went through was different
, who on October 26 gave birth to Ignacio Valentino amid strict measures for being positive for coronavirus.
Her husband could not witness the delivery because he is a possible carrier of the virus.
“I was asymptomatic.
I found out I was infected when I had a routine swab.
Everything was very hard,
I was crying to have a cesarean section
”, she points out with the bitter taste of a memory that today translates into the satisfaction of having her son in her arms.
The head of the Obstetrics service of the Italian Hospital, Gustavo Izbizky, explains that in asymptomatic women, childbirth can proceed with the same standards as in the absence of SARS COV-2 infection.
“The only difference is that the personnel have to have an adequate level of protection.
In many institutions, they are even carried out in places specifically destined to the care of Covid patients ”, he points out.
Breastfeeding with Covid
The Argentine Society of Pediatrics (SAP)
recommends maintaining breastfeeding
both in Covid-positive women and in mothers without infection but who, due to their health conditions or work situation, have been inoculated against the coronavirus.
It is that a report prepared jointly by the national committees of Breastfeeding, Infectology and Neonatal Feto Studies, which included a systematic review of 50 studies, affirms that
the presence of the SARS-CoV-2 coronavirus genome in breast milk is little common (5% of cases)
and that, in such situations, the infection occurs in the newborn asymptomatically or with mild symptoms (they do not counteract the battery of benefits provided by breastfeeding).
In addition, it refers that 8 out of 10 women with Covid (83%) have a
high presence of antibodies against the coronavirus in breast milk
.
Although there are no scientific data on the possible effects of the vaccine on infants (the research studies excluded the population of children, pregnant women and nursing mothers), the WHO itself recommends not to suspend it after vaccination.
Medical checks on a pregnant woman.
“As the study vaccines do not contain replicative viruses, they are unlikely to pose a risk to the nursing child and must be weighed against the potential benefit of neonatal protection against infection, through passive transfer of antibodies from breast milk. ”, Highlights Lucrecia Bossi, pediatrician and neonatologist, Secretary of CEFEN.
The work of the Argentine Society of Pediatrics coincides with that established by the Ministry of Health of the Nation in relation to the possibility of inoculating with the Sputnik V vaccine to lactating women when they present a high risk of exposure to SARS infection -CoV-2 and that it cannot be avoided, or that they have underlying diseases that include them within the groups at high risk of serious complications and / or death from Covid-19.
Can the newborn be infected?
Medical research to date suggests that a pregnant woman is not at higher risk than a nonpregnant of contracting Covid-19.
Unlike Zika, which can be transmitted through the placenta and affect the development of the baby, data published in scientific journals
do not refer to any alarming risk
.
Specialists consulted by
Clarín
agree that the transmission of the baby during pregnancy by transplacental passage
is infrequent
(the transmission of the virus through the placenta is exceptional).
“
At most, it can amount to 2%
.
This probability is so low because for it to occur, the mother must have the SARS COV2 virus in her blood, which happens in only 10% of pregnant women who have a serious illness ”, argues Fernando Neuspiller, director of IVI Buenos Aires.
And he adds: "The form of intrapartum infection is also anecdotal, through the mother's vaginal secretions (even with the blood that is shed during it)."
After birth, babies can acquire Covid-19 through the transmission of respiratory droplets that are in the air, just like adults.
"
Every newborn is feasible to be infected through close contact with his mother
(when he is positive for Covid) who can breastfeed him with adequate care and protection," says Izbizky.
Specialists recommend maintaining social distance with newborns.
Millions of pregnant women in the world had their children having taken Covid during pregnancy.
Néstor Vain, head of Neonatology of the sanatoriums of Trinidad Palermo San Isidro and Ramos Mejía, refers that, in case of infection,
the disease is usually mild in newborns
, although it is more serious than pediatric.
“However, there are some reports of severe cases such as that of a baby who was infected in a family gathering of 20 people when he was 15 days old.
It was very bad and could have had definitive consequences ”, observes Vain and insists on the importance of
maintaining social distance with newborns
to prevent them from being infected after birth.
Nacho Pérez Tomasone, head of the Obstetrics unit, cared for more than 30 pregnant women with Covid (in all trimesters) so far in 2021. “Most of those who become infected have asymptomatic or mild symptoms.
Some may get worse, but do not have major complications from the pregnancy (they may require oxygen), "he explains.
"
The most common thing is that the baby is not infected after birth
. If it does, it is through close contact. In the Otamendi (Sanatorium), a PCR is done on every newborn of a mother with active Covid (who has it in the moment of delivery) ”, she says.
Likewise, it highlights that the recommendation of the Ministry of Health is to observe and not study the baby if it is asymptomatic.
Can the baby be born with antibodies?
At the beginning of March, a study in the United States, which was supported by the National Institutes of Health of that country, included 84 pregnant women, of whom 13, vaccinated during the third trimester of pregnancy, had their babies during the research:
10 passed antibodies to their babies
.
The study also included a group of lactating women, and showed that antibodies can also be passed to babies through breast milk.
On March 17, it emerged what is believed to be the first case in the world of a baby born with IgG antibodies against SARS-Cov-2 protein S detectable in umbilical cord blood after maternal vaccination.
Spontaneous vaginal delivery occurred in Florida three weeks after the first dose of Moderna and provides evidence that the antibodies generated by the vaccine can cross the placenta.
A few days ago, the first case was announced in Spain: Bruno was born with antibodies thanks to the inoculation that his mother received in the third trimester of pregnancy.
However, studies are still lacking to determine the degree of protection it provides to the baby and whether being born with antibodies guarantees immunity.
New Yorker Kate Glaser was 39 weeks pregnant and tested positive for Covid.
Photo: Facebook.
Naturally, anyone who becomes infected with SarsCov2 will generate antibodies against the virus.
During pregnancy, the mother makes three classes: IGG, IGM, and IGA.
For a matter of size, only the first will cross the placenta and usually do so during the second and third trimesters of pregnancy.
"The only way in which the other antibodies could be found in a newborn is if during or before delivery there is
a small rupture of the placenta
that causes these antibodies to cross the placental barrier", Neuspiller develops.
For his part, Izbizky argues that if the infection was weeks before delivery, the baby acquires the antibodies through the placenta.
"It is not yet known whether they are protective, so they are not sought in clinical practice either," he illustrates.
Although Vain highlights: “We did a study where we measured antibodies and the presence of viruses in the baby's blood.
The results are being analyzed, but there are already reports that antibodies were found in babies of mothers who had Covid.
It is not known how protective they are because the amount is very variable ”.
Can the vaccine in pregnant women generate an immune response in the fetus?
To date, published studies show that the application of RNA vaccines generates IGG antibodies in the mother that cross the placenta and protect the fetus.
"The antibody finding is higher when patients receive two doses of the vaccine against just one," says Neuspiller.
“The ability of the fetus to respond with antibodies to the pregnant woman's vaccine has not yet been studied because few were inoculated, since they did not enter into the research studies.
Today, it is known that the pregnant woman with the vaccine does not seem to have major complications, she responds with antibodies and the baby receives those antibodies ”, Vain synthesizes.
EMJ