COVID-19 during pregnancy increases health risks
Tuesday January 17th 2023
Pregnant women who contract COVID-19 have a seven times increased risk of losing their lives and a significantly heightened risk of being admitted to an intensive care unit, according to research published today.
The study, led by scientists at the George Washington University Milken Institute School of Public Health, Washington D.C., USA, also suggests having COVID-19 during pregnancy increases the risk of the baby needing to be admitted to intensive care.
Lead author Dr Emily Smith, an assistant professor of global health at the university, said: “This study provides the most comprehensive evidence to date suggesting that COVID-19 is a threat during pregnancy.
“Our findings underscore the importance of COVID-19 vaccination for all women of childbearing age.”
The findings, published in BMJ Global Health, are based on pooled individual patient data from 12 studies conducted in Ghana, China-Hong Kong, Italy, Kenya, Nigeria, South Africa, Spain, Sweden, the Democratic Republic of Congo, Turkey, Uganda, and the USA, involving 13,136 pregnant women.
The researchers found that compared to uninfected pregnant women, pregnant women with COVID-19 infection had a seven times higher risk of dying during pregnancy or childbirth; more than three times greater risk of being admitted to the intensive care unit; about 15 times higher risk of needing ventilator treatment; about 23 times higher risk of developing pneumonia; and more than five times higher risk of thromboembolic disease.
The study also found that neonates born to women who were infected with COVID-19 were almost twice as likely to be admitted to a neonatal intensive care unit after birth and had a greater risk of being born prematurely.
However, unlike previous reviews, COVID-19 infection was not linked to a heightened risk of stillbirth at or beyond 28 weeks of pregnancy, nor restricted growth.
Smith said despite the very serious health risks, more than 80 countries still do not recommend that all pregnant and lactating women get the COVID vaccine.
She points out that many women of childbearing age in the USA and other countries remain unvaccinated, with some hesitant because they do not believe the virus poses risks to young women or because they feel unsure about the safety of the vaccine during pregnancy.
Even some doctors are reluctant to give the vaccine to a pregnant woman, even though it is recommended, adds Smith.
“This study shows the risk of getting COVID-19 for both mother and baby,” Smith said. “All countries, including the United States, should make access to COVID vaccines an urgent priority in order to save lives and prevent health problems.”
The research had some limitations, including that the selection of pregnant women with COVID-19 depended on when and how they were tested for SARS-CoV-2; this changed over time across sites along with the availability of test kits. Also, the analysis did not consider the differential impact of SARS-CoV-2 variants that have emerged and s outcomes were not monitored for a clinically meaningful period.
However, the researchers said: “These findings underscore the need for global efforts to prevent COVID-19 during pregnancy through targeted administration of vaccines and non-pharmaceutical interventions.”
Smith ER, Oakley E, Grander GW et al. Adverse maternal, fetal and newborn outcomes among 1942 pregnant women with SARS-CoV-2 infection, as compared to 11194 negative pregnancies: A individual participant data meta-analysis. BMJ Public Health 17 January 2023; doi: 10.1136/bmjgh-2022-009495
Tags: Childbirth and Pregnancy | Flu & Viruses | North America
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