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Covid-19 Antibody Therapy in Pregnancy

Monoclonal antibody (mAb) therapy is used to decrease the risk of COVID-19 related severe illness, hospitalization and death and is recommended for use in pregnancy by multiple professional societies. 

A recent joint statement from Minnesota Department of Health (MDH), Minnesota section of the American College of Obstetricians and Gynecologists (Minnesota ACOG), Allina Health, Mayo Clinic, and University of Minnesota states, “Due to the risks for poor outcomes associated with COVID-19 in pregnancy, mAb therapy is highly recommended in this population, regardless of severity of illness.”   

To date, we have not heard of specific safety concerns related to the use of mAb therapy in pregnancy.  Although pregnant people were not included in the initial studies, antibody therapy is used for other conditions and is considered safe.  Two published cases on the use in pregnancy found no evidence of pregnancy complications or adverse treatment effects.  The Mayo Clinic monoclonal antibody treatment program has treated 51 pregnant patients with mild to moderate COVID-19.  No patient progressed to severe COVID-19 illness requiring hospitalization and were without adverse drug reaction to the mother or the fetus.  

Minnesota Resource Allocation Platform (MNRAP) is an online tool that connects people and healthcare providers with COVID-19 monoclonal antibody appointments.  Patients, caregivers, family members or healthcare providers can use this tool to refer people for an appointment. 

Unvaccinated pregnant patients with COVID-19 infection or who have had close contact with a COVID-19 positive person are strongly encouraged to sign up for monoclonal antibody therapy on MNRAP.  Vaccinated pregnant patients may also sign up but can be reassured that their course of illness will likely be mild due to their vaccination status. 

Eligibility for mAb therapy includes mild to moderate COVID-19 symptoms, not hospitalized for COVID-19, tested positive for COVID-19 within 10 days of symptom onset.  If a patient is deemed eligible for treatment, MNRAP will pass your information along to the closest health care facility with an available appointment.  Final decisions about treatment are up to healthcare providers at that facility. 

If you test positive for COVID-19, stay hydrated and use acetaminophen (Tylenol) as needed for fever or body aches (max dose of 1,000 mg every 6 hours).   Monitor and call your healthcare provider for significant shortness of breath (a change from your pregnancy baseline), fever unresponsive to acetaminophen (Tylenol) and/or inability to keep food or fluid down. 

The best prevention againt COVID-19 infection and severe illness continues to be vaccination.  Vaccines and boosters are recommended for pregnant, postpartum and lactating people to reduce risk for COVID-19 and consequent complications.  Find a vaccine here.