COVID-19 and CO Monitoring in Pregnancy

The following information from NHS England & Improvement has been cascaded through Maternity Safety Champions and MTP networks.

We are aware that there has been some concern around carbon monoxide (CO) testing and the risk of disease transmission in the context of the coronavirus outbreak.

In view of the unprecedented circumstances we suggest it is appropriate to pause CO testing of pregnant women during this period as a precautionary measure. It should be re-introduced as soon as the COVID-19 situation has resolved to a background risk.  

As a precautionary measure, the government has classed pregnant women as a group at risk of severe illness with COVID-19. People who smoke have an increased risk of more severe respiratory infections.  It has therefore never been more important for a pregnant woman to look after her respiratory health, and It is vitally important that we help smokers to quit. We recommend that all women are still asked about their smoking status at antenatal appointments and given appropriate advice and support.

The following advice can be used by healthcare professionals seeing pregnant women during this period:

• Midwives and doctors should still ask about and document smoking status at booking and 36 weeks, provide Very Brief Advice and refer women who smoke to specialist stop smoking support on an opt-out basis. 
• Advise women that they are much more likely to stop smoking with support (be aware that this local provision may also have had to change recently e.g. from face to face support to telephone consultations).
• Continue to provide or recommend women use nicotine replacement as part of their quit attempt e.g. a patch as well as a faster acting product, such as inhalator, gum or spray. Women may wish to consider purchasing this whilst awaiting their stop smoking appointment
• This situation should be regularly reviewed and plans put in place to reinstate CO monitoring as soon as it is considered safe to do so.

Further information from ASH and the Smoking in Pregnancy Challenge Group on Smoking and COVID-19:

https://mailchi.mp/d32d7fa3540e/smokefree-pregnancy-information-network-update7-may-4355618?e=07d5101809