There is not yet much scientifically substantiated knowledge about post-COVID and pregnancy. In May 2024, a was published in the Lancet article published in which the state of affairs regarding this was summarized with recommendations.[1] This article serves as the basis for the information below in which the recommendations have been translated into the Dutch context.
Getting pregnant
Women and men with post-COVID may also wish to have children. It is unclear whether they experience reduced fertility. However, common symptoms of post-COVID, such as fatigue, decreased libido, and dry mucous membranes, can make it more difficult to conceive. Furthermore, we know that post-COVID sometimes involves a disruption of the hormonal balance. Whether this also affects fertility is unknown.
Risks of pregnancy for mother and child
- Women with post-COVID have a higher risk of gestational diabetes and gestational hypertension.
- Babies of mothers with post-COVID have a higher risk of preterm birth and low birth weight than in the general population. Premature birth and low birth weight lead to increased health risks for the baby, both around birth and in the longer term.
Researchers do not yet fully understand what causes the increased risks for mother and child. This may be related to the course of post-COVID illness: women with post-People with COVID are often very tired and have many symptoms that affect their health. More research is needed to fully understand this.
Post-COVID can affect a pregnancy, and conversely, a pregnancy can also influence post-COVID symptoms. A pregnancy can lead to (temporarily) more or fewer symptoms, or to different post-COVID symptoms than the pregnant woman had previously.
Workshop Leading
- Is there a desire to have children, and is the woman experiencing post-COVID symptoms? Then a preconception consultation is advisable so that topics regarding illness, medication, fertility, pregnancy, and childbirth can be discussed and prepared for.
- If you are taking medication, discuss this with your treating physician before pregnancy. They can then assess whether adjustments are necessary during pregnancy.
- In the management of post-COVID, the focus is on energy management and symptom treatment (where possible). This applies to both pregnant and non-pregnant patients. If you are pregnant, indicate that you are experiencing post-COVID when registering with a midwife. Also explain any limitations.
- POP (Psychiatry, Obstetrics, Pediatrics) clinics are available in various regions. Sometimes these multidisciplinary clinics already have experience in supporting pregnant women with post-COVID. The general practitioner can inquire about this and assess whether a referral to such a clinic is appropriate.
- During pregnancy, it is advisable to closely monitor the growth of the unborn child. The mother's health must also be closely monitored due to the increased risk of gestational diabetes and gestational hypertension.
- Because pain can worsen orthostatic conditions (such as POTS), it may be necessary to administer pain relief sooner during labor. This is not possible during a home birth. Therefore, a hospital delivery may be necessary.
Points of attention
- When wishing to conceive, it is good to ensure the best possible starting point: an optimal energy balance for the patient, treatment of symptoms where possible and treatment of co-existing diseases, and a good lifestyle (healthy eating, as much exercise as possible, no smoking, no alcohol).
- During and after pregnancy, a good care and support system is needed: the partner will have to be able to cope with many of the sleepless nights. In addition, care is required if the mother has (too) little energy. It may also be necessary to organize household support and/or make (temporary) home modifications or use assistive devices.
- For pregnant women who work, it is important to involve the occupational physician at an early stage to ensure a good balance between work and energy. Consider starting maternity leave earlier and taking additional parental leave to allow time to recover and adjust to the new situation.
Sources
[1] Maissonneuve E, Favre G, Boucoiran I et. al. 2024. Post-COVID-19 condition: recommendations for pregnant individuals. The Lancet Regional Health – Europe 2024;40: 100916
