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Major new review highlights risks of Covid-19 in pregnancy

Major new review highlights risks of Covid-19 in pregnancy

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CNN

Pregnant women and their developing babies are at higher risk of severe outcomes if they get Covid-19, and now a major international review is helping to highlight just how devastating those risks can be.

The study was based on data from 12 studies from as many countries, including the United States. In total, the studies included more than 13,000 pregnant women – about 2,000 who had a confirmed or probable case of Covid-19. The health outcomes for these women and their babies were compared to about 11,000 pregnancies in which the mother tested negative for Covid-19 or antibodies to it at the time of their birth.

In studies, about 3% of pregnant women with Covid-19 need intensive care and about 4% need any type of critical care, but this is much higher than the number of pregnant women who need that type of care outside Covid-19 infection.

Compared to pregnant women who were not infected, those who contracted Covid-19 were nearly 4 times more likely to be admitted to the intensive care unit. They were 15 times more likely to be ventilated and 7 times more likely to die. They also had a higher risk of preeclampsia, blood clots and problems caused by high blood pressure. Babies born to mothers with Covid-19 are at higher risk of preterm birth and low birth weight.

Previous studies have suggested that Covid-19 may increase the risk of stillbirth, but this study did not find the same link.

Still, the findings paint a clear picture showing that pregnancy risks are amplified by Covid-19 infections.

“It’s very clear and it’s even consistent, you know, whether we’re talking about Sweden, where we have really generally great pregnancy outcomes in other countries that you know have bigger problems with maternal morbidity and mortality, that the presence of COVID and pregnancy increases the risk for both mother and baby,” said lead study author Emily Smith, who is an assistant professor of global health at George Washington University.

The study has some caveats that may limit how applicable the findings are to pregnant individuals in the Omicron era.

First, the studies were conducted relatively early in the pandemic, at a time when most people were still unvaccinated and uninfected. This means that the people in the study were likely at higher risk not only because they were pregnant, but also because they were immunologically naïve to the virus – they didn’t have any pre-existing immunity to help them fight off their infections .

Since then, many pregnant women have been vaccinated or had Covid-19, or both. As of the first week of January, about 72% of people in the US are pregnant have had their primary series of Covid-19 vaccines and about 95% of Americans are evaluated have had Covid-19 at least once or been vaccinated against it, according to data from the Centers for Disease Control and Prevention. This means that they are likely to have some immune memory against the virus that can help protect against severe outcomes.

However, this immune memory seems to fade over time. CDC data shows that only 19 percent of pregnant women have received an updated booster, meaning many people may not have as much protection against the virus as they think.

Lead study author Emily Smith, who is an assistant professor of global health at George Washington University, says the study’s findings reflect the risk of Covid-19 and pregnancy in unvaccinated people.

Unfortunately, Smith says, many countries still don’t have clear guidelines recommending vaccination during pregnancy. And there are some parts of the world, like China, that still have a significant portion of their population that has never been infected.

For people trying to weigh the risks and benefits of getting vaccinated against Covid-19 during pregnancy, Smith says this study helps tip the scales in favor of vaccination.

“It pays to protect yourself during pregnancy,” Smith said.

She says this study did not look at the benefits of vaccination during pregnancy, but other studies have, showing a large reduction in the risk of stillbirth, preterm birth and severe illness or death for the mother.

“So it’s kind of a complementary story,” Smith said.

Dr. Justin Lappen, director of maternal-fetal care at the Cleveland Clinic, praised the study and said its findings reinforce and advance previous research that found Covid-19 significantly increases the risk of severe outcomes for mother and baby . He did not participate in the research.

He says the findings highlight the importance of preventing and treating Covid-19 in pregnant women.

Therapies that are otherwise indicated or recommended should not be withheld specifically because of pregnancy or breastfeeding, Lapen wrote in an email to CNN.

The study is published in the journal BMJ Global Health.


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