如果您刚怀孕、在过去 42 天内怀孕（近期怀孕），或者正在进行母乳喂养，您可能会担心 2019 冠状病毒病（COVID-19）会对您和宝宝产生影响。您可能对 COVID-19 疫苗的安全性也有疑问。以下是您需要了解的一些事项。
怀孕期间吸烟
孕妇感染 COVID-19 的总体风险较低。但是，已怀孕或刚怀孕的女性患 COVID-19 重症的风险更高。重症意味着可能需要住院，接受重症监护或通过呼吸机来帮助呼吸。患有 COVID-19 的孕妇也更有可能在妊娠第 37 周开始前分娩（早产）。患有 COVID-19 的孕妇发生死产和妊娠丢失等问题的风险也可能增加。
黑人或西班牙裔孕妇更有可能受 COVID-19 病毒感染影响。患有糖尿病等其他疾病的孕妇也可能因 COVID-19 患上重症的风险更高。
如果您出现 COVID-19 症状或接触过 COVID-19 患者，请立即联系您的医务人员。建议您接受 COVID-19 病毒检测。就诊前，提前打电话给医务人员，告知您的症状和可能接触过病毒的情况。
如果您感染了 COVID-19 且已怀孕，医务人员可能建议您接受影响 COVID-19 病毒的药物治疗。这些药物可减缓病毒的自我复制和传播能力。这些药物可通过服用药片或在门诊通过手臂针头（静脉注射）输注液体给药。
治疗方案可能还包括多喝水和多休息。您可能还需要服药来缓解发热、疼痛和咳嗽。如果您病情严重，则可能需要住院治疗。
对产前护理的影响
询问医务人员在就诊期间会采取哪些预防措施来保护您，或者可否选择在线产前护理。咨询是否有任何适合居家使用的工具，如血压监测仪或脉动血氧计（监测血氧水平的装置）。为了充分利用在线就诊时间，请提前准备好问题清单并做好详细笔记。在线分娩课程也可能是一个选择。
如果在孕期出现某些高风险状况，可能无法选择在线就诊。询问医务人员您的护理可能受到哪些影响。
分娩建议
如果您在孕晚期身体健康，那么分娩的某些方面可能会照常进行。但要做好灵活应对的准备。
如果您计划进行引产或剖腹产，您和您的陪护人员可能需要在进院前接受 COVID-19 症状筛查。您可能会在进入分娩室之前再次接受筛查。如果您出现 COVID-19 症状，医生可能会重新安排引产或剖腹产。
为了保护您和宝宝的健康，有些医疗机构可能会限制留在分娩室的人数。分娩后的探视可能也会受到影响。此外，在住院期间，您和陪护人员可能每天都要接受症状筛查。请向医务人员咨询可能适用的任何限制。
如果您感染了 COVID-19 或因出现相关症状而等待检测结果，请在产后住院期间配戴贴合度良好的口罩，并在护理新生儿前清洁双手。尽可能与婴儿保持适当距离。采取这些措施后，新生儿感染 COVID-19 病毒的风险将会降低。
但如果您的 COVID-19 病情很重，则可能需要暂时与新生儿隔离。
产后指导
产后护理是一个持续的过程。与医务人员讨论产后线上和线下约诊。
在此期间，您可能担心自己和家人的健康。关注心理健康。采取预防措施降低感染 COVID-19 病毒的风险时，请向家人和朋友寻求帮助。
如果在分娩后不久出现严重的情绪波动、食欲不振、极度疲劳以及缺乏生活乐趣，可能是患上了产后抑郁症。如果您认为自己可能患上抑郁症，请联系医务人员。例如，您的症状没有自行消退、您在照顾宝宝或完成日常任务方面有困难，或者您有伤害自己或宝宝的想法。
母乳喂养注意事项
研究表明，COVID-19 病毒不太可能通过母乳传播给婴儿。更令人担忧的是，受感染的母亲是否会在哺乳时通过呼吸道飞沫将病毒传播给婴儿。
如果您感染了 COVID-19，请采取措施以避免将病毒传播给您的宝宝。请在哺乳前洗手，并在哺乳期间以及与宝宝的距离小于 2 米时佩戴合适的口罩。如果您用吸奶器吸奶，请在接触任何吸奶器或奶瓶部件之前洗手，并请根据建议正确清洗吸奶器。如有可能，请一位身体健康的人给宝宝喂食挤出的母乳。
孕期或哺乳期接种 COVID-19 疫苗
如果您处于孕期或哺乳期，建议您接种 COVID-19 疫苗。接种 COVID-19 疫苗可预防 COVID-19 引发重症。接种疫苗还可以帮助孕妇产生保护胎儿的抗体。研究表明，如果母亲接种两剂 mRNA COVID-19 疫苗，例如辉瑞－生物科技或莫德纳 COVID-19 疫苗，则所生婴儿在出生后的六个月内因感染 COVID-19 而住院的风险较低。
接种 COVID-19 疫苗不会导致 COVID-19 病毒感染，对孕妇或胎儿而言也是如此。所有 COVID-19 疫苗均不使用引起 COVID-19 的活病毒。另外，请谨记，mRNA COVID-19 疫苗不会改变 DNA 或导致基因变化。
一项在 40,000 多名女性中开展的大型研究发现，孕期接种 COVID-19 疫苗不会对孕妇或胎儿造成重大风险。该研究中的大多数女性均接种了 mRNA 疫苗，如辉瑞－生物科技或莫德纳 COVID-19 疫苗。
这项研究提供的证据进一步表明，孕期接种 COVID-19 疫苗与早产风险增加无关。另外，母亲接种 COVID-19 疫苗不会增加胎儿出生体重低的风险。
如果您处在备孕期或未来有生育计划，也建议您接种 COVID-19 疫苗。目前没有证据表明任何 COVID-19 疫苗会导致生育能力问题。
如果您尚未接种 COVID-19 疫苗，或者您应该接种加强针剂，在大多数情况下，mRNA 疫苗（如辉瑞－生物科技或莫德纳 COVID-19 疫苗）是首选。
如果您在接种两剂式 COVID-19 疫苗的第一剂后怀孕，建议您接种第二剂疫苗。此外，还建议孕妇按时接种 COVID-19 加强针。可能的话，共同生活的其他人也应该接种 COVID-19 疫苗。如您有疑虑，请向医务人员咨询风险和益处。
您能做些什么
您和家人可以采取许多措施，以便降低感染 COVID-19 病毒或传播该病毒的风险。
- 接种疫苗。
- 避免与生病或出现症状的任何人密切接触。
- 如果您未完全接种疫苗，请在室内公共场所与他人保持距离。如果您患重症的风险较高，这一点尤为重要。
- 如果所在地区有大量 COVID-19 住院病例和新发 COVID-19 病例，则无论您是否已接种疫苗，均应在室内公共场所佩戴贴合度良好的口罩。CDC 建议您经常佩戴贴合度良好、舒适性佳且最具防护性的口罩。
- 经常用肥皂和清水洗手至少 20 秒，或者使用酒精含量至少 60% 的免洗洗手液。
- 避开人群，并避免进入空气流通不畅的室内场所。
- 咳嗽或打喷嚏时，用手肘或纸巾遮住口鼻。用过的纸巾应直接扔掉。立即洗手。
- 避免触摸眼睛、鼻子和嘴巴。
- 定期清洁和消毒频繁接触的表面，例如门把手、电灯开关、电子产品和台面。
- 如果生病，请勿上班、上学或前往公共场所；除非外出看病，其余时间请留在家中自行隔离。患病期间，避免乘坐公共交通工具、计程车和网约车。
最为重要的是，要集中精力照顾好您自己和您的宝宝。联系医务人员，讨论您的任何顾虑。如果您在控制压力或焦虑方面遇到困难，请与医务人员或心理健康顾问谈谈应对策略。
July 20, 2023
- Breastfeeding and caring for newborns if you have COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/pregnancy-breastfeeding.html. Accessed Feb. 15, 2022.
- Berghella V, et al. COVID-19: Overview of pregnancy issues. https://www.uptodate.com/contents/search. Accessed Feb. 15, 2022.
- Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: Maternal coronavirus infections and pregnancy outcomes. Archives of Pathology & Laboratory Medicine. 2020; doi:10.5858/arpa.2020-0901-SA.
- COVID-19 vaccines for people who would like to have a baby. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/planning-for-pregnancy.html. Accessed Feb. 14, 2022.
- COVID-19: How to protect yourself & others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed Feb. 15, 2022.
- COVID-19: Considerations for inpatient obstetric healthcare settings. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html. Accessed Feb. 15, 2022.
- COVID-19 and pregnancy: Questions and answers. https://www.uptodate.com/contents/search. Accessed Feb. 14, 2022.
- Lipkind HS, et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — Eight integrated health care organizations, United States, December 15, 2020-July 22, 2021. MMWR Morbidity and Mortality Weekly Report. 2022; doi:10.15585/mmwr.mm7101e1.
- Hughes BL, et al. COVID-19: Antepartum care of pregnant patients with symptomatic infection. https://www.uptodate.com/contents/search. Accessed Feb. 15, 2022.
- Zeng H, et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA. 2020; doi:10.1001/jama.2020.4861.
- Barbieri RL. COVID-19 obstetric practice recommendations. NEJM Journal Watch. https://www.jwatch.org/na51340/2020/04/16/covid-19-obstetric-practice-recommendations. Accessed Feb. 15, 2022.
- FAQs: Management of infants born to mothers with suspected or confirmed COVID-19. American Academy of Pediatrics. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers/. Accessed Feb. 15, 2022.
- Pregnant and recently pregnant people. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html. Accessed Feb. 14, 2022.
- COVID-19: People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed Feb. 14, 2022.
- Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. Accessed Feb. 15, 2022.
- COVID-19 vaccines while pregnant or breastfeeding. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html. Accessed Feb. 14, 2022.
- COVID-19 vaccination considerations for obstetric-gynecologic care. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care. Accessed Feb. 15, 2022.
- Stay up to date with your vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Accessed Feb. 15, 2022.
- Activities and gatherings. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/index.html. Accessed Feb. 17, 2022.
- Halasa NB, et al. Effectiveness of maternal vaccination with mRNA COVID-19 vaccine during pregnancy against COVID-19-associated hospitalization in infants aged < 6 months — 17 states, July 2021-January 2022. MMWR Morbidity and Mortality Weekly Report. 2022; doi:10.15585/mmwr.mm7107e3.
- COVID-19 FAQs for obstetrician-gynecologists, obstetrics. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics. Accessed Feb. 25, 2022.
- Use and care of masks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. Accessed Feb. 28, 2022.
- CDER scientific review documents supporting emergency use authorizations for drug and biological therapeutic products, COVID-19. U.S. Food and Drug Administration. https://www.fda.gov/drugs/coronavirus-covid-19-drugs/cder-scientific-review-documents-supporting-emergency-use-authorizations-drug-and-biological. Accessed April 18, 2023.
- AskMayoExpert. COVID-19: Drug regimens and other treatment options. Mayo Clinic; March 23, 2023.