COVID-19 during pregnancy

By trimester

Weeks 1–13

1st trimester

Infection in the first trimester is documented far less often in the research than later infection and appears to carry a lower risk of severe maternal illness, though one study found the miscarriage rate was nearly double in those with a first-trimester infection (17.6%) compared with those without (9.7%). Contact your provider if you test positive or develop symptoms.

Weeks 14–27

2nd trimester

Second-trimester COVID-19 sits between the other two trimesters for documented risk: rates of hospitalization and ventilator need were higher than in the first trimester but well below third-trimester rates in the same research. Continue routine prenatal care and call your provider with any new or worsening symptoms.

Weeks 28–birth

3rd trimester

Third-trimester COVID-19 carries the highest documented risk of the three: research links it to more frequent hospitalization, breathing complications, preterm delivery, and placental abnormalities than infection earlier in pregnancy. Report any COVID-19 symptoms to your provider promptly at this stage.

What does the evidence show for COVID-19?

• Getting COVID-19 in the third trimester is linked to far more severe illness than infection earlier in pregnancy: one study found 83% of third-trimester patients needed hospitalization and 27% needed a ventilator, compared with roughly half and 12% or less earlier in pregnancy. 1
• COVID-19 caught in the third trimester is associated with higher rates of preterm labor and low birth weight than an uninfected pregnancy at the same stage, per a study comparing 304 infected patients with 910 uninfected controls. 2
• Third-trimester COVID-19 infection carries a notably higher rate of placental abnormalities and preterm delivery than infection earlier in pregnancy, with one retrospective study finding affected patients were 23 times more likely to have a placental abnormality. 3
• Pregnant and recently pregnant people have a higher chance of getting very sick from COVID-19 than people who are not pregnant, including higher chances of preterm delivery, stillbirth, preeclampsia, blood clots, and emergency c-section. 4
• Research so far hasn't found a clear link between COVID-19 infection during pregnancy and any specific birth defect, and passage of the virus from parent to fetus during pregnancy appears to be rare. 4

When should I call my provider about COVID-19?

Worsening shortness of breath is the clearest warning sign with COVID-19 in pregnancy. Research on third-trimester infection found breathing difficulty was linked to nearly seven times higher odds of needing hospitalization, and close to two-thirds of third-trimester patients with severe illness had respiratory distress. Chest pain, a high fever that will not come down, confusion, or bluish lips or face need immediate medical attention. Any noticeable drop in the baby's usual movement alongside COVID-19 symptoms is also worth an urgent call to your provider, particularly in the third trimester when complications are most common in the research above. None of these lists replace your own judgment: if this symptom worries you, that on its own is enough reason to check in with your healthcare provider.