Coronavirus (COVID-19)

Last Update: 04 Mar 2025

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Table of content

1. What Is COVID-19? 2. Why Treating? 3. Before Medications 4. Medications 5. Breastfeeding 6. Key Takeaways 7. Research limits

Welcome to our Fact Sheet on COVID-19 during pregnancy and breastfeeding. The information given is based on current research and may be updated with new scientific knowledge. This information does not replace personalized advice from healthcare professionals.

1. What Is COVID-19 and How to Recognize the Symptoms?

Coronavirus disease, known as COVID-19, is a viral infection caused by the SARS-CoV-2 virus. COVID-19 first emerged during the global pandemic named after it. Nowadays, it remains a common infection, especially during the falls and winter months. It affects the respiratory system, including your nose, throat, and lungs.

The virus spreads easily from person to person, usually through droplets when someone coughs, sneezes, or talks. You can also catch it by touching contaminated surfaces and then touching your face.

Symptoms of COVID-19 typically appear 2 to 14 days after exposure. The severity of symptoms varies from one person to another. Some people are asymptomatic (don’t have any symptoms) while others can be very sick. Healthy individuals usually recover within 2 to 4 weeks.

COVID-19 can feel similar to a cold or the flu, with symptoms like:

Sore throat
Runny nose
Sneezing
New or worsening cough
Shortness of breath or difficulty breathing
Fever (temperature equal to or more than 38°C (110.4°F))
Chills
Fatigue or weakness
Muscle or body aches
New loss of smell and/or taste
Headache
Abdominal pain, diarrhea and vomiting

If you experience symptoms during pregnancy, follow social distancing measures and consult your healthcare provider. Taking preventive measures, such as getting vaccinated and washing your hands can help keep you and your baby safe.

2. Why Is It Important to Treat COVID-19 Infection During Pregnancy?

During pregnancy, your body goes through many changes, including a natural weakening of the immune system, which can make you more vulnerable to illnesses like COVID-19. Pregnant people with COVID-19 are at higher risk for severe illness, including the need for intensive care or mechanical ventilation.

Understanding Risks in Pregnancy

Research helps us estimate the risks linked to common pregnancy-related conditions. Miscarriages, congenital malformation , premature births, and other complications can happen in any pregnancy for many reasons. These are called background risks.

So far, if left untreated, COVID-19 infection have been link to a higher chance of serious complications that could affect both you and your baby, such as preeclampsia, pneumonia, breathing difficulties, or hospitalization.

Table 1 below provides a summary of the potential impacts of untreated COVID-19 during pregnancy compared to the background risks. Keep in mind that these risks can be influenced by factors like the type of SARS-CoV-2 variants, the severity of the symptoms, and the presence of other risk factors (e.g. person’s age, ethnicity, maternal obesity, type 2 diabetes).

What are malformations like spina bifida?

Learn more

Table 1. Potential impacts of untreated COVID-19 during pregnancy.

For who?	What?	What does research say?
For the pregnant person	Ability to get pregnant	Studies have not shown an impact of the infection on the ability to get pregnant .
	Miscarriages	Most studies did not find a higher risk of miscarriages compared to the background risk .
	Preeclampsia, hypertension	Some studies found an increased risk of developing preeclampsia and hypertensive disorders .
	Hospitalisation	Some studies found an increased risk of intensive care unit admission .
	Other complications	Some studies found an increased risk of pneumonia, thromboembolic disease, and maternal death .
For the unborn child	Congenital Malformations	Having the COVID-19 during pregnancy has not been proven to cause birth defects . But a high fever from COVID-19 in early pregnancy may slightly raise the risk of birth defects. .
	Growth	Some studies found a possible increased risk of low birth weight (less 5 pounds 8 ounces [2,500 grammes]) was found .
	Premature Birth	Mixed results in research. Some have found a slight increased risk of giving birth before 37 weeks and other studies have not .
	Neonatal Health	Slightly increased risk of intensive care unit admission after birth .
For future child/adult	Brain Development	Too early to know if the infection during pregnancy can have an impact on brain development (e.g. ADHD, autism, learning delays). So far, no association has been found .
For future child/adult	Long-term health issues	Too early to know if the infection during pregnancy can have an impact on the child’s health later in life .

* The risks that increased when compared to the background chance in the population are in bold.

It’s also important to remember that COVID-19 can be passed to your newborn, which we call vertical transmission. As such, preventing COVID-19 during pregnancy helps protect your baby, especially in those early months when they are most vulnerable.

Preventive measures, such as getting COVID-19 vaccines and seeking medical care if symptoms arise, help lower the risks for both you and your baby. When you get the COVID-19 shot during pregnancy, you pass on valuable protection to your baby, which is important given that babies under 6 months are too young to be vaccinated. This protects your baby during the time they are most vulnerable to related complications.

3. What Can I Do to Manage My COVID-19 Before Medications?

If you a COVID-19 and are experiencing symptoms, there are several steps you can take to help manage your infection before starting any medications:

Rest: Allow your body to recover by getting plenty of rest.

Stay Hydrated: Drink water, clear broths, or herbal teas to avoid dehydration.

Stay Isolated: Avoid close contact with others, especially your baby, to prevent spreading the flu.

Practice Good Hygiene: Wash your hands regularly and wear a mask to reduce transmission risks.

These steps can help manage your symptoms and support your recovery until you consult your healthcare provider for further guidance

4. Medication Options for COVID-19

The best way to prevent infections and complications for pregnant women is to get vaccinated against COVID-19. These vaccines have been studied and are considered safe during pregnancy. In Canada, three vaccines are available and can be taken at any trimester. They are updated regularly to provide a protection against the new variants:

Messenger RNA (mRNA) vaccines:

Moderna Spikevax COVID-19 vaccine

Pfizer-BioNTech Comirnaty COVID-19 vaccine

Protein subunits vaccines:

Novavax Nuvaxovid COVID-19 vaccine

If you are infected by COVID-19, some non-prescriptive (over-the-counter) medications may be used to relieve symptoms, such as acetaminophen (Tylenol®) and non-steroidal anti-inflammatories (NSAIDs) (e.g. Advil® and Motrin®). It’s important to always consult your healthcare provider before use, especially if using NSAIDs in the third trimester.

Moreover, some medications can be prescribed by your healthcare team to prevent COVID-19 complications. Your healthcare provider can help you find the best option for your situation.

Table 2: Some medications available in Canada to treat COVID-19.

Medication Types	Medications Names	Brand Names
Antivirals	Remdesivir	Veklury®
	Nirmatrelvir/ Ritonavir	Paxlovid®
	Tocilizumab	Actemra®
Pain relief	Acetaminophen, Paracetamol	Tylenol®
Non-steroidal anti-inflammatory drugs (NSAIDs)	Ibuprofen	Advil®, Motrin®
Non-steroidal anti-inflammatory drugs (NSAIDs)	Naproxen	Naprosyn®, Aleve®

To know more about a specific medication, please consult the associated Fact Sheet and always discuss with your healthcare provider before making changes to your medication intake during pregnancy.

How do I know which one to take?

Each medication has its benefits and potential risks, which is why it’s important to work with your healthcare team—including your pharmacist, nurse, doctor, or midwife—to make the best decision for you and your baby. They will guide you in making the best decision for both you and your baby by considering your symptoms, stage of pregnancy, and any other health conditions you may have.

When it comes to COVID-19 vaccines, all options are available during pregnancy, but the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends mRNA vaccines (like Pfizer and Moderna) as they have the most safety and efficacy data for pregnant people.

For managing symptoms like fever or pain, acetaminophen (Tylenol®) is the preferred choice during pregnancy, while non-steroidal anti-inflammatories (NSAIDs) (such as Advil® or Motrin®) are generally avoided.

If medications are needed to prevent COVID-19 complications, your healthcare team will weigh the benefits and risks, as more studies on these treatments during pregnancy are still needed. Always consult with your healthcare provider to ensure you are choosing the safest and most effective option for you and your baby.

5. Will I Be Able to Breastfeed?

If breastfeeding is what you desire, know that it is still possible while you have the infection. The virus does not pass through breast milk. In fact, breast milk provides important antibodies that help protect your newborn’s health.

To reduce the risk of spreading COVID-19 to your baby, it’s recommended to:

Wash your hands thoroughly before feeding
Wear a mask while breastfeeding or handling your baby

By following these simple precautions, you can keep breastfeeding while keeping your baby safe.

Breastfeeding is a personal choice. Remember that if you have questions about your situation, you can seek help from your healthcare professional (doctor, nurse, pharmacist) or a lactation consultant.

Key Takeaways

Pregnant women with COVID-19 are at higher risk of intensive care unit admission and ventilation than non-pregnant women with COVID-19.
COVID-19 infection may result in risks for the pregnant person and the unborn child, such as preeclampsia, newborn low birth weight, and neonatal intensive care unit admission.
The virus may be transmitted to the fetus during pregnancy but is not present in breast milk.
It is possible to prevent COVID-19 infection and complications with vaccination and preventive measures, which are recommended during pregnancy.
Non-prescribed (over-the-counter) medications may be used during pregnancy to relieve symptoms and medications may be prescribed to prevent complications. Always valid with your healthcare provider before taking medications during your pregnancy.

Research Is Great, But It's Not Perfect

Making informed health decisions during pregnancy also involves understanding the current scientific knowledge, which has some limitations. Here’s what our team have found about the quality and quantity of research on COVID-19 during pregnancy:

Recent illness: Since it is a recent illness, we continue to track research’s findings on the potentials impact of a COVID-19 infection on pregnancy

Limited sample sizes: Many studies have a small sample size, which makes estimates of association less precise.

Incomplete data: Vaccination status is not always known.

Variable definitions: The definition of a COVID-19 infection may differ. It can be based on self-reported symptoms, or COVID-19 tests results (RT-PCR, antigen test, serology test)

Underestimated factors: Other factors, like existing health conditions in the pregnant person, are not always considered in the study results.

These factors can affect the accuracy and reliability of current research, which is why it’s important to consult your healthcare team for personalized advice.

For more information, you can also consult the following resources:

https://immunize.ca/covid-19

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines/how-vaccinated.html

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/pregnancy-childbirth-newborn.html

References

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