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At Increased Risk for Severe Illness from COVID-19
CDC is reviewing this page to align with updated guidance.
If you are pregnant or were recently pregnant, you are more likely to get severely ill from COVID-19 compared to people who are not pregnant. Pregnancy causes changes in the body that could make it easier to get very sick from respiratory viruses like the one that causes COVID-19. These changes in the body can continue after pregnancy.
Severe illness means that a person with COVID-19 may need:
People with COVID-19 who become severely ill can die. See why pregnancy is included in the list of underlying medical conditions that increase a person’s risk of severe illness from COVID-19.
Other factors can further increase the risk for getting very sick from COVID-19 during or recently after pregnancy, such as:
People with COVID-19 during pregnancy are more likely to experience complications that can affect their pregnancy and developing baby compared to people without COVID-19 during pregnancy. For example, COVID-19 during pregnancy increases the risk of delivering a preterm (earlier than 37 weeks) or stillborn infant. People with COVID-19 during pregnancy may also be more likely to have other pregnancy complications.
See the latest data on birth and infant outcomes among pregnant women with COVID-19.
COVID-19 vaccination is recommended for people who are pregnant , breastfeeding, trying to get pregnant now, or might become pregnant in the future . In addition, everyone who is eligible, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get a booster shot and stay up to date with their COVID-19 vaccines. If you have questions about getting vaccinated, talking with your healthcare professional might help, but is not required.
If you are pregnant and have questions about COVID-19 vaccine
If you would like to speak to someone about COVID-19 vaccination during pregnancy, you can contact MotherToBaby. MotherToBaby experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday 8am–5pm (local time). To reach MotherToBaby:
Getting vaccinated prevents severe illness, hospitalizations, and death. People who have not received a COVID-19 vaccine should get vaccinated as soon as possible and continue masking. To maximize protection from variants and prevent possibly spreading the virus to others, people who are up to date with their COVID-19 vaccines should wear a mask indoors in public in areas with a high COVID-19 Community Level . With the emergence of variants, this is more urgent than ever. Learn more about what you can do when you have been fully vaccinated when you are up to date with your COVID-19 vaccines.
It is especially important for people who are or were recently pregnant, and those who live or visit with them, to take steps to protect themselves and others from getting COVID-19 .
Limit in-person interactions with people who might have been exposed to COVID-19, including people within your household, as much as possible. If you or someone in your household is sick with COVID-19, follow guidance for isolation .
Keep all of your healthcare appointments during and after pregnancy. Visit with your healthcare provider for all recommended appointments. If you’re concerned about going to your appointments in person because of COVID-19, ask your healthcare professional what steps they are taking to protect patients from COVID-19, or ask about telemedicine options. If you need help finding a healthcare professional, contact your nearest hospital, clinic, community health center, or health department .
If you are diagnosed with COVID-19, learn about breastfeeding and caring for newborns when the mother has COVID-19 . Current evidence suggests that breast milk is not likely to spread the virus to babies.
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Pregnant Patient
Image Wisely, a joint initiative of ACR, RSNA, ASRT and AAPM, provides information to the medical community to promote radiation safety in medical imaging.
Fergus V. Coakley, MD, University of California, San Francisco, CA
Dianna D. Cody, PhD, The University of Texas MD Anderson Cancer Center, Houston, TX
Mahadevappa Mahesh, PhD FACR, Johns Hopkins University School of Medicine, Baltimore, MD
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Four key points should be remembered about performing CT in pregnant patients:
The radiation dose to the fetus from a typical CT study of the maternal pelvis is variable and depends on the gestational age and scanning parameters, but typically ranges from about 10 to 50 mGy (1-3).
The fetal dose for an average-size patient can be estimated from the technique used to scan the pregnant uterus using dose conversion factor of 10.8 mGy/100 effective mAs, for 120 kV abdominal exams (4). (Effective mAs is defined as tube current in mA multiplied by rotation time in seconds divided by pitch.) For example, an effective mAs 222 for a CT scan of the pelvis would result in a fetal dose of 24 mGy (10.8 x 2.22). The baseline risk of childhood cancer is about 1.0 to 2.5 per 1000 (5). Estimates for the extra risk of childhood cancer from a fetal radiation dose of 1000 mGy range from 0.022 (Oxford Survey Childhood Cancer) through 0.028 (Life Span Study of atomic bomb survivors) to 0.060 (expert statistical review) (4, 6). After classifying these risk values as low, intermediate, and high, the excess risk of cancer for a variety of fetal doses would then be as follows:
The lowest achievable dose is zero! That is, non-ionizing options are always preferable to any test with ionizing radiation in pregnant patients. In particular, most pregnant patients with pelvic pain should initially be scanned with ultrasound. When the diagnosis with ultrasound is not clear, imaging can be performed with MRI, in particular when appendicitis is suspected (7). Other strategies for CT dose reduction, which are equally applicable to CT in pregnant patients, have been described elsewhere (8) and are summarized in Table 2. More information can be obtained by referring to the ACR Practice guideline for imaging pregnant patients (9), which lists ultrasound as the initial imaging modality of choice for right lower quadrant pain in pregnancy, left lower quadrant pain in women of reproductive years, flank pain in pregnancy, and acute pelvic pain in the reproductive age group.
Table 2: Potential strategies and measures to reduce CT radiation dose and to address patient concerns regarding radiation risk.
Provide patient information material
Review CT protocols and indications
Promote alternative non-ionizing studies
Empower technologists to adjust protocol
Chen M.M., Coakley F.V., Kaimal A., Laros R.K. Jr. “Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation," Obstetrics & Gynecology , August 2008; 112(2 Pt 1): 333-40.
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