On February 6, it was reported that the newborn of a pregnant woman with new coronavirus (2019-nCoV) pneumonia was detected to be infected with 2019-nCoV within 36 hours after birth, which raised questions about whether the virus could cause intrauterine infections, and then triggered concerns about the possibility of vertical transmission of the virus from mother to child. There are even rumors spreading on the Internet, such as “the fetus conceived by a patient with nCoV cannot be born”. Vertical mother-to-child transmission can occur through the transmission of pathogens from the mother’s placenta to the fetus, or during delivery, when pathogens in the mother’s blood invade the baby’s body through the baby’s broken skin and mucous membranes, causing the baby to become ill. When it comes to the above case, the fact that the details of many important clinical information of the case are not presented in detail does not exclude the possibility that the neonate was infected through the respiratory tract after birth. Vertical transmission of coronaviruses (including SARS and MERS viruses) from mother to child has also not yet been reported. It is not possible to conclude from this single case whether intrauterine infection could have occurred. Therefore, there is no evidence to support the possibility of vertical mother-to-child transmission of 2019-nCoV. Is it appropriate to become pregnant during the outbreak? Pregnancy is not suitable during the outbreak for the following reasons. First, the population is generally susceptible to 2019-nCoV, especially pregnant women. Pregnant women are already susceptible to respiratory pathogens, and after pregnancy, hormonal changes in the pregnant woman’s body will occur significantly, affected by the increase in estrogen, the respiratory mucosa will be significantly thickened by congestion and edema, which is more likely to lead to respiratory infections; the immune function during pregnancy is in a state of relative inhibition; and with the development of pregnancy, the pregnant woman will have a series of physiological changes in other systems, and once the infection is more likely to develop into a serious illness, putting pregnant women at higher risk. Second, pregnant women with 2019-nCoV infection are also at greater risk of fetal damage. This is due to the fever and respiratory distress caused by nCoV, reduced blood oxygen levels, and even other organ functions may be compromised. As a result there is also an increased risk of miscarriage, preterm labor, intrauterine distress, and stillbirth. Although there is no evidence to determine the direct effects of 2019-nCoV on the fetus, on February 6, 2020, a newsletter was published in The Lancet titled “The 2019-nCoV epidemic: what about pregnancies?”, which provides an analysis of the risks to pregnant women and fetuses in the face of the ravaging epidemic. In 2002-2003, 12 pregnant women were infected with the SARS virus, and 4 of the 7 early pregnancies were miscarried. Two of the five women in the middle and late stages of pregnancy had fetal growth restriction and four had preterm deliveries (one spontaneous and three induced). three women died during pregnancy. In a retrospective analysis of 11 pregnant women infected with the MERS virus, 10 had adverse outcomes, 6 newborns required intensive care unit admission, and 3 died during pregnancy. Two neonates were born prematurely due to severe respiratory failure in their mothers. Considering that 2019-nCoV appears to have similar pathogenic potential to SARS and MERS viruses, it is possible that 2019-nCoV could lead to severe adverse maternal or fetal outcomes, or both (Source: 2019-nCoV epidemic: what about pregnancies? DOI:https:// doi.org/10.1016/S0140-6736(20)30311-1). Third, treatments for neococcal pneumonia may themselves have some effect on the fetus. This includes antiviral drugs, antibiotics, and hormone therapy. Fourth, during the epidemic, pregnant women’s nutrition, psychological factors, and exercise may receive some impact, and thus may also have some impact on pregnancy outcomes. What to do if you are pregnant and infected with 2019-nCoV? The Expert Advice on Novel Coronavirus Infections in Pregnancy and Puerperium, published on February 4, 2020, states that 2019-nCoV-infected pregnant women should be centrally admitted according to the designation of the healthcare administration and informed of the risk of adverse pregnancy outcomes. First, there are no significant adverse outcomes for 2019-nCoV infection in late pregnancy. The Lancet published online on February 12 a small-sample study on the combination of 2019-nCoV in late pregnancy. The authors retrospectively analyzed the epidemiological characteristics, clinical manifestations, multiple laboratory and imaging findings, maternal and fetal complications, and pregnancy outcomes of nine cases of laboratory-confirmed 2019-nCoV infection admitted to Zhongnan Hospital of Wuhan University from Jan. 20 to Jan. 31. The study suggests that the clinical characteristics of patients infected with 2019-nCoV during pregnancy were similar to those of non-pregnant adult patients, and none of the nine patients progressed to severe pneumonia or died during the observation period. The authors also mention that the outcome of 2019-nCoV infection on the pregnant women themselves is inconclusive, given the small number of cases, the fact that they were all late-pregnant patients, and the fact that they were managed in a very timely manner. In addition, all nine neonates were born alive, with no neonatal asphyxia or birth infections. Therefore, there is no evidence that 2019-nCoV infection can lead to serious adverse neonatal outcomes or that 2019-nCoV can lead to vertical transmission from mother to child. However, after birth, newborns should be isolated for at least 14 days, during which time direct breastfeeding is not recommended. Mothers are advised to express milk regularly to ensure lactation until 2019-nCoV infection is excluded or cured before breastfeeding is feasible. Second, for early and mid-pregnancy is termination of pregnancy? Currently, there are few reported cases on the impact of 2019-nCoV infection on pregnancy outcomes, and most of them are in late pregnancy, when the fetus is in a period of low sensitivity to antiviral drugs, although pregnant women also undergo anti-2019-nCoV infection treatment. Therefore, there is insufficient evidence to show whether the condition of patients is exacerbated after 2019-nCoV infection; there is insufficient evidence to show that there is a risk of mother-to-child transmission of 2019-nCoV; and there is insufficient evidence to show whether 2019-nCoV itself is harmful to the embryo and the fetus. Infection in early pregnancy with severe clinical symptoms such as persistent high fever, coupled with the fact that treatment against the infection itself may have some effect on the embryo, should be of particular concern. Despite all the possible effects of infection with 2019-nCoV on the pregnant woman and the fetus, this does not mean that a pregnant woman should terminate her pregnancy as soon as the infection is detected. Once a pregnant woman is infected with 2019-nCoV, a multidisciplinary consultation should be conducted to comprehensively consider whether to continue the pregnancy based on the gestational week, the development of the fetus, the severity of the disease, and the wishes of the pregnant woman herself as well as her family. In conclusion, there is a lack of data on the impact of 2019-nCoV infection on pregnancy outcomes, and it is recommended that systematic screening should be performed on any pregnant woman with suspected 2019-nCoV infection. Confirmed cases should be closely followed up with the mother and fetus for a long period of time. REFERENCES: 1. Yunhui Wang, Rui Zhang, Jianping Zhang, et al. Effects of SARS infection on pregnancy outcome and fetus and infant. Chinese Journal of Perinatal Medicine 2004 , 7: 155-158. 2. Zhang Jianping, Wang Yunhui, Chen Leining, et al. Clinical analysis of acute respiratory syndrome in middle and late pregnancy. Chinese Journal of Obstetrics and Gynecology, 2003, 38: 516. 3. Huijun Chen, PhD, Juanjun Guo, MS Chen Wang, PhD; et al. Clinical charactertistics and intrauterine vertical transmission potential of COVID-19 infection in patients with intrauterine hypertension. potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Published: February 12,2020 DOI: http://doi.org/ 10.1016/S0140-6736(20)30360-3. Source: Chinese Association of Preventive Medicine, Liu Zhaofen, researcher, Chinese Association of Preventive Medicine, Maternal and Child Health Division, Wang Linhong, chairman, Chinese Association of Preventive Medicine.