Interviews

"Babies are protected throughout pregnancy by the lack of vertical transmission of COVID-19"

 Foto: Alba Castillo Photography

Foto: Alba Castillo Photography

13/05/2020
Marga Casado
"Thanks to technology, there has been physical distance between people, but not social distance"
Rafael Caparrs, professor and member of the University of Granada's Applied Neuropsychology for Children, Adults and the Elderly research group, and course instructor for the UOC's Master's Degree in Neuropsychology

 

The SARS-CoV-2 coronavirus is new but every day we know a little more about it, thanks to the work done by scientists around the world. Rafael Caparrós, a psychologist and course instructor for the UOC's Master's Degree in Neuropsychology, has studied one of its aspects: how COVID-19 infection during pregnancy affects mothers and their babies. His paper, based on a scoping review, has been published in the Revista Española de Salud Pública, a journal specialized in public health published by the Spanish Government's Ministry of Health. Caparrós is currently a faculty member of the Universidad de Granada's Department of Nursing, after working for 15 years as a male midwife. With all due caution, he has some good news: "So far, the SARS-CoV-2 coronavirus has not been found in any of the fluids that could transmit the virus from the mother to the baby: it hasn't been found in the mother's breast milk nor in the amniotic fluid nor in the umbilical cord blood".

 

Your scoping review is the first study performed in Spain on the health of pregnant mothers and newborn children related with COVID-19. Why did you decide to focus this study on pregnant women with COVID-19? Was there some underlying hypothesis?

Since my research line is concerned with pregnancy and newborns, I couldn't miss the opportunity to do something on this subject, seeing how the situation was. As all this is very new, I really didn't know what we would find. It was known from other coronavirus infections that mothers and newborn children could be affected.

The conclusion from your report is good news: COVID-19 is not transmitted to the foetus...

Yes. The number of studies performed to date is very small and they are based on short-term effects: the long-term effects are still unknown. But it does seem that the virus has not been found in any of the fluids that could transmit it from the mother to the baby: it hasn't been found in the mother's breast milk nor in the amniotic fluid nor even in the umbilical cord blood... Some babies have become infected but this may be due to faulty handling or faulty technique during natural birth or when performing the caesarean section.

Pregnant women are included in the risk groups for COVID-19 but only as a precaution. Does this mean that the effects of an infection would be the same for them as for anyone else?

Yes, provided that they have no underlying disease, their symptoms are usually very mild. That doesn't mean that all possible precautions should not be taken, as with anyone else. We still need to be very cautious due to the lack of studies in general and the lack of population-based studies in particular: the studies that are currently being published are almost all based on case studies, written by someone who works in a hospital where there has been a case of a pregnant woman with COVID-19. It is not really possible to draw broad conclusions from such small studies.

Research is racing against the clock and it seems that society is now realizing its value. However, a scoping review doesn't need many resources... What resources did you have?

These are the resources you need to perform a review: the first is to really want to do it and, if you've got that, all you need is to know the procedure so that you don't make any mistakes in the process, a computer with an internet connection and access to published papers. You don't need a laboratory or any large infrastructure. I'm quite proud of this study but really it is very simple; I was able to do it from home during lockdown.

What consequences and applications do you think your article may have?

The number of visits to my Research Gate profile has surprised me. It is being read by researchers from India, South America, Australia... It is a grain of sand; it is not the definitive study that will solve this problem, but I do think that it will have some impact and help make decisions.

In what types of decision do you think that it could help?

There is currently a lot of reluctance to allow infected mothers to breastfeed their babies. I am working on another review related with vertical transmission. In the 29 studies included in the review, none of the babies were breastfed; all of them were given formula. That is taking a step backwards. Also, many centres prefer to perform caesarean deliveries because it seems easier to prevent any transmission during birth, instead of vaginal delivery, which is the natural process. These are decisions based on defensive medicine, on fear.

What advice would you give to expecting mothers?

I would tell them to follow the advice given by the midwives and obstetricians who are monitoring their pregnancy, that they continue to attend the prenatal care appointments at both primary and specialized care centres and that they shouldn't be afraid to go to these centres when recommended by medical professionals. The studies seem to say that there is no vertical transmission; this means that the baby would be protected throughout the pregnancy by this lack of transmission from mother to child.

Do you have any general recommendations for protecting the population's mental health while the pandemic lasts?

One very important thing we all have is technology, which has helped us a lot during the pandemic to stay close to our loved ones. Social support is fundamental for mental health. People have talked a lot about social distancing during the pandemic but I don't think there really has been social distancing. What there has been is physical distancing between people. In many cases, technology has even brought people closer than before the pandemic.

During lockdown, many people have said that they have found it harder to read, or think, that they have felt a sort of mental woolliness. Can neuropsychology provide any explanation for this?

Yes, I would say that in part stress is to blame for this, as it has a direct effect on the brain. There is also a sensation of not knowing what will happen in the future, of not knowing how long we will have to continue like this, and I think that this has made us live more in the present. Those who have learned to take things as they come are the ones who have fared best.