Science Vs - Coronavirus: Pregnant in a Pandemic

Episode Date: May 8, 2020

How bad is the coronavirus for pregnant people and babies? Producer Meryl Horn is digging into this question for today’s episode. And it’s personal, because Meryl is pregnant and living in the pandemic hot spot that is New York City. We talk to Professor Emily Oster, pathologist Dr. David Schwartz, and obstetrician Dr. Suzanne LaJoie. Also: SWIMMING DINOSAURS!? Here’s a link to our transcript: bit.ly/2YKzD7e  This episode was produced by Meryl Horn with help from me Wendy Zukerman, Rose Rimler, Laura Morris, Michelle Dang and Sinduja Srinivasan. We’re edited by Blythe Terrell with help from Caitlin Kenney. Fact checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. A big thanks to all the researchers we got in touch with for this episode, including Dr Neel Shah, Dr William Schweizer, Dr Edward Mullins, Dr David Shaffer, Dr Gianluca Esposito, Dr István Bókkon, Dr Vassilios Fanos, Dr Reut Avinun, Dr Anastasia Topalidou, Dr Alan Sroufe, Dr Pehr Granqvist, and Dr David Baud. And thanks to all the women who shared their stories with us: Alexandra Schinasi, Courtney Desman, and Caitlin Bertin-Mahieux. And special thanks to the Zukerman family, Joseph Lavelle Wilson and Chris Suter. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. This coronavirus is screwing around with all of our lives, making things feel scary and uncertain. And for one of our producers, Meryl Horn, all that scariness and uncertainty is amplified. A lot. Meryl takes it from here. This has been a weird time for me. It's been weird for everyone. We're in a pandemic.

But on top of that, I'm also pregnant. If you listened to our episode on the fertility cliff, you'll know that getting pregnant was a struggle for me. But it happened. And now my husband, Chris Suter, and I are expecting a baby girl due in July. Do you think we should name her Corona? I was just thinking, like, Pandy? I don't know. It's just, you know, short for pandemic. Or Rona. I think anything better than Pandy.

Chris and I live in New York City, which is one of the hot spots of this pandemic. And that's made me worried about being pregnant right now because there are scary stories of babies and moms getting this. This newborn tested positive for COVID-19 at just 12 days old. The first infant is believed to have died from the coronavirus. An investigation is now underway. 28-year-old nurse who had tested positive for COVID-19 died here on Sunday. A few days earlier, she had undergone an emergency cesarean and given birth to a daughter.

And all of this has been kind of freaking me out. out what if i get sick and then give it to the baby or i i get super sick while i'm pregnant like that seems like it'd be terrible yeah occasionally in that like moment between wake and sleep at night i'll be like almost falling asleep and i'll get almost like a rush of adrenaline. Just have this, I don't know, holy shit, sensation. Yeah. So I decided to find out how scared I really should be here. And I'm a big science nerd. I spent a decade working in biology labs and also have a PhD in neuroscience. So I dove into the research on this. I wanted to know what science can tell us about how bad this could be if I got the coronavirus.

Like what could end up happening to me and to my baby? That's coming up after the break. Bumble knows it's hard to start conversations. Hey. No, too basic. Hi there. Still no. What about hello, handsome? Who knew you could give yourself the ick?

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I'm Steve Strogatz. And this is... Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. Welcome back. Today, we're looking into how dangerous this coronavirus is for pregnant people and their babies. After all, we know that with some viruses, they can make you more sick if you're pregnant.

We see this with the flu and with some other coronaviruses. The virus is part of a family of viruses that includes SARS, and SARS and MERS were actually both quite bad for pregnant women. That's Professor Emily Oster from Brown University. Emily is an economist who does deep dives into pregnancy research. She's written a book about it, and her stuff has become a sort of pregnancy bible for a lot of people, including me. And now she's turned her attention towards the coronavirus.

Emily told me that when you dig into the stats on pregnant people, this fear that the virus could be more dangerous for us, it hasn't played out. So when we actually look at the case of the coronavirus, it does not look like pregnant women are at higher risk. And so in a sense, that is, I think, quite reassuring. Yeah, so those stories of people getting really sick, that does happen, but it doesn't seem to be very common. Like one study out of China looked at around 120 pregnant people with COVID-19, and it found that for 92% of them, the disease was mild.

Other studies are coming out with similar findings that most pregnant people aren't getting very sick. That made me feel better. Yeah. And I think at this point, we would probably know if this was a huge risk just because, you know, a lot of people have now had this. And pregnant women are having a lot of exposure to the medical system. And so if it were the case that, you know, infected pregnant women were showing really bad symptoms or really bad outcomes, I think that's something we would be hearing more about. So it doesn't seem like I have to worry too much about how being pregnant could affect me. But the thing I'm more worried about is what would happen to my baby. I wanted to know if I got sick, could she get it while she's still in the womb?

For this, we turn to David Schwartz, a professor at Augusta University in Georgia, who studies pregnant moms and diseases. And he loves the placenta. It's my favorite organ. It's just bloody fascinating. I mean, it's very well designed. Whoever engineered that really knew what he or she or they were doing. I look down the microscope at it every day. So let's borrow that microscope to look at what happens when a virus comes along. David told us that the placenta is a barrier between the fetus and the mom's body. For most viruses to infect the fetus, they'll have to get across that barrier. Essentially, a virus would have to go, in most cases, would enter into the placenta

through mom's blood and then penetrate placental tissue of the fetus. This is what happens with Zika virus. This is what happens with Ebola virus. A whole host of viral agents. So we know that some viruses can cross the placenta. But is that happening here? Well, scientists have looked for the virus and the placentas from a handful of babies whose moms have had COVID. And in a couple of cases, they've gotten a positive. It looked like the virus might have gotten across that barrier.

Plus, there's also been a few babies who have been born with coronavirus antibodies, suggesting that they might have been exposed to the virus before they were born. But this isn't much data to go off of, just a few cases. So when we asked David if he thinks that the virus could cross the placenta, here's what he said. I think it's possible. But I don't think it's going to be frequent or common. I think it will be the exception rather than the rule. So one reason to be skeptical that this is happening a lot is that when scientists test babies as soon as they're born, they're typically not infected.

Like we found reports for 14 babies born to moms with the coronavirus. These babies got tested right after they came out, and none of them had the virus. David also told us that when he looked at other similar respiratory viruses, they usually don't cross the placenta. It happens, but it's really rare. There were several cases of flu, but you have almost a billion cases of flu every year. This is exceedingly rare. And two other coronaviruses, SARS and MERS, none of which had documented maternal fetal transmission. Since other viruses like this don't tend to cross the placenta, that made me feel a lot better. But we still need more data on this coronavirus just to be sure. This is a brand new

virus on an almost hourly basis, right? We're getting a thousand new articles every week in the literature on this. But things are moving so quickly. So I think we will have some of these questions answered fairly shortly. I wish I had more answers for to my baby if I get sick while I'm pregnant. That's comforting. Another comforting thing is that when researchers look at breast milk, they haven't found any virus in it. So we probably don't need to worry about breast milk. But my baby could pick this virus up from somewhere else. How bad would that be? The best study we have for this comes out of China. Researchers looked at over 300 infants who got diagnosed with COVID. Then they looked to see how sick they got, how many of them just had mild symptoms like a runny nose or a cough, and then how many of the

babies got really sick, like they had organ failure or they started to turn blue because they weren't getting enough oxygen. And they found that about 10% of them were in this really sick, like they had organ failure or they started to turn blue because they weren't getting enough oxygen. And they found that about 10% of them were in this really sick category. I asked Emily about this. One of the most stressed out times that I've been during this pregnancy was there was this study that came out from China and one of their kind of take homes was that infants were vulnerable to infection. That's super scary, but it is always the case that infants are going to be higher risk from illnesses, which is like a sort of callous way to talk about it. But I think that we, you know, we do want to remember and put this in context.

So like infants are just more vulnerable to dying from all sorts of things, not just coronavirus. Yes. Unfortunately, like, yeah, I mean, yes, infant mortality is higher than child mortality. Okay. But it's very, very, but like infant mortality from the coronavirus

is really low. Really, really, really low. In the US, the best numbers we could find from the CDC say that out of several hundred infants with confirmed cases of COVID, four of them have died. So while there have been some scary news reports, this seems to be rare. But there still is that one in 10 babies which will have pretty serious consequences, like turning blue or having trouble breathing. And the medical community is taking that really seriously. Some hospitals have taken some pretty drastic measures.

They're separating babies from infected moms. Is that the right move? That's coming up after the break. Welcome back. So while there's a lot we don't know here when it comes to pregnancy and the coronavirus, it's looking like most pregnant people will be fine if they get infected and probably won't pass this on to their babies in the womb.

But we're also learning that, like with other viruses, babies rarely do die from this, and sometimes they get really sick. And because of that, some hospitals are separating infected mums from their newborns while in the hospital. Here's producer Meryl Horn again. Yeah, so this separation thing is kind of a big deal because for years there's been this big shift towards keeping moms and babies together

after birth. They want you to have skin-to-skin contact and to have the baby stay with you in the room. My hospital is like this. They encourage new moms to keep their babies nearby as much as possible. So to find out more about what's going on with the separation stuff, I called up my OB, Dr. Suzanne Lajoie, who's at home right now with her kids. And we're doing remote learning and it's just a little challenging, but it's fine. Yeah, yeah. I'm kind of glad my baby's still in me for now. For now. Suzanne's sort of the cool OB at my practice. She has pink hair. I wanted to ask her about the separation policy.

What would happen after the birth if I'm positive? So this is where the controversy lies. So we have been separating mom and baby. And women who are COVID positive. Basically, they would take my baby to the hospital nursery after the birth. And they'd take care of her there until it's time for us to go home, which could be a couple of days. Some women who've gone through this say it's really painful.

I think it's heartbreaking to separate a new mom and a newborn. I think it's the last thing anyone wants to do. Like the safety is the priority, right? The safety is the priority. But Suzanne also said that with this separation thing, no one is going to just take my baby away from me. It's more like the doctors make a recommendation, but then I'm the one who decides. We reached out to more than a dozen hospitals across the country. And while they might recommend splitting you up, bottom line, it's ultimately up to the mom.

So moms can refuse. Should we wrestle a newborn out of a mother's arms? Absolutely not. Ever. A mom can ultimately refuse. And if you refuse to be separated from your newborn, then that's that, and he or she will be with you. But how do you decide?

When the American Academy of Pediatrics looked at the research, they said that the safest thing to do is to separate the COVID-positive moms from the newborns. But they messed up the math in their report. So remember that study from China where they looked at the babies diagnosed with the coronavirus? In the AAP guidelines, they say about 25% of the babies got really sick. But it was really about 10%. I actually asked them what was up with this mistake, and they said they're looking into it. So that's the AAP. And even more confusing is that the World Health Organization is saying the opposite. They're saying that babies should stay with the moms

even if the mom is positive. And the CDC is basically staying at this, saying the decision should be made on a case-by-case basis. It's confusing. Like, yeah, what are we to make of this if we're just trying to make this decision and it seems like nobody is agreeing? Right. No, if I'm feeling confused about what to tell mothers, then I would think especially you're going to be confused. You know, the WHO, which is a world-renowned,

I mean, come on, this is like the top of the top, is saying don't separate. And then on the practical community level, the separation is happening. Okay, so even though these recommendations are all over the place, this idea isn't coming out of left field. In some cases, hospitals already separate moms and newborns, like when the mom has some potentially serious infection that she could pass on to her baby, like the flu, TB, or the chickenpox. But could this be bad for the baby? As you might imagine, there aren't studies that take healthy babies away for a couple of days and then give them back to their parents to see if it messes up the baby. I asked Emily Oster what she thinks based on all her research about parenting. If your worry is like, if this happens, I will not

be able to bond with my baby. I think that that's, that is probably not true. You know, many people are able to bond with kids who they don't meet until they're, you know, several, several months old. And so although in the moment, I am sure that this experience would be awful. I say that as someone who, you someone who has two kids and can't really imagine that. But thinking about the long-term, if the worry is that somehow this will mean that your kid is not socially adapted

or doesn't love you, I don't think there's anything in the data that would tell us that that was something to be worried about. With all of this in mind, I went back to Suzanne for her take. Do you know what you would do? Oh my gosh.

I hate questions like that. If the doctor recommended that we be separated, I would separate. For me, I think I would try to make that separation thing work because the risk of my baby getting affected and really sick, even if the chance is small, it feels worse than getting separated at the hospital. And I'd probably try to keep the separation up too once we got home until I recovered. From what we understand with the science now, it looks like most pregnant women and their babies will be fine, even if they do get infected. But I'm still

curious about what giving birth in the midst of a pandemic will be like. So I called up a bunch of women to ask them about their experiences. So he arrived on April 12th. She was born at 9.03 p.m. on the 17th. Gave birth last week on April 27th. My doctor was like, I don't want to scare you, but I think you're having this baby today. My contractions were getting stronger and stronger want to scare you, but I think you're having this baby today. My contractions were getting stronger and stronger. Oh my gosh, this is happening. The birth process was pretty, I guess, normal.

But I had the surgical mask. I didn't even notice it. You're in so much pain that anything else doesn't even matter. We didn't have any visitors. My mom and dad couldn't come. My brother, he wasn't even allowed to come in to see the baby. It's hard to explain, but I can't believe that I've created this life and that it's a human being that grew inside of me with a nervous system and perfect fingers and ears and hair. It's just unbelievable it's been stressful and i keep playing this game i'm like is it postpartum or is it pandemic you know which which one is it hi cuckoo you want to say hi After hearing these stories, I sat down to talk with my husband, Chris, about what that day might be like for us.

This all feels really tough. Do you think we're still going to be able to, like, enjoy meeting our baby? Yeah, definitely. I don't have any doubt about that. Yeah. Yeah. What do you think we're going to tell her about this time when she's old enough to understand it? Oh, man.

I don't think she'll ever understand it. You know, we'll sound like our grandparents talking about whatever ridiculous thing they lived through when they were our age. And we'll be like, okay, grandma, whatever. Today, a fishy dinosaur discovery. Time for some non-coronavirus content and see the secret short. Today, a fishy dinosaur discovery that's set to shake up Jurassic Park. Well, actually, this is about the Cretaceous period. But anyway.

So, for a long time, researchers thought that dinosaurs lived their best life on land, with some species maybe poking a toe or two in the water to catch fish. But dinosaurs didn't go swimming, did they? Well, recently, scientists dug up some very curious fossils in the Saharan Desert. Now, the Saharan Desert might not seem like a great place to go swimming, but 100 million years ago, there was water everywhere there. Now, when scientists put together the curious fossils, they realised that this dino, which is a Spinosaurus, it had this weird tail. Like, imagine a flexible oar stuck onto its bum.

To see what this tail might have done out in the real world, researchers created a plastic model of it and then attached it to a robotic arm that let them measure how much thrust it could generate. They then compared that with other animals that swim with their tails, like crocodiles and newts. And here's what they discovered. This dinosaur tail seemed to act very, very similar to those other swimmers, suggesting that this spino dino might have been a swimmer as well, splashing around, hunting for tasty snacks. That's Science Versus. Hello?

Hey, Meryl Horne. Hello. How many citations in this week's episode? We have 89 citations. 89. And if people want to see these, where should they go? They can follow the links from our show notes to the transcripts. Thanks, Meryl.

Thanks, Meryl. Thanks, Wendy. Fact-checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Begala, Emma Munger and Bobby Lord. A big thanks to all the researchers we got in touch with for this episode, including Dr. Edward Mullins, Dr. David Schaefer, Dr. Gianluca Esposito, Dr. Istvan Bokon, Dr. Vassilios Vanos, Dr. Reut Avinun, Dr. Anastasia Topolato, Dr. Alan Shroof, Dr. Per Granquist and Dr. David Boud. And thanks to all the women who shared their stories with us. Alex Skinazzi, Courtney Desmond, and Caitlin Bertont-Mayu.

And a special thanks to the Zuckerman family, Joseph Lavelle-Wilson and Chris Suter. I'm Wendy Zuckerman. Back to you next time.