Major new review highlights risks of Covid-19 during pregnancy
Pregnant women and their developing babies are at greater risk of severe outcomes if they contract Covid-19, and now a large, international study is helping to highlight just how devastating those risks can be.
The study draws on data from 12 studies from as many countries — including the United States. In all, the studies included more than 13,000 pregnant women – about 2,000 of whom had a confirmed or probable case of Covid-19. The health outcomes for these women and their babies were compared with about 11,000 pregnancies in which the mother tested negative for Covid-19 or antibodies to it at the time of delivery.
Across all studies, about 3% of pregnant women with Covid-19 needed intensive care, and about 4% needed any type of intensive care, but this was far more than the number of pregnant women who needed that type of care outside of Covid-19. 19 infections.
Compared to uninfected pregnant women, those who contracted Covid-19 were almost 4 times more likely to be admitted to an 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 who had Covid-19 were at higher risk of premature birth and low birth weight.
Previous studies have shown that Covid-19 can increase the risk of stillbirth, but this study did not find that same link.
However, the findings paint a clear picture showing that pregnancy risks are heightened by Covid-19 infections.
“It’s very clear, and even consistent, you know, if we’re talking about Sweden where we have really generally good pregnancy outcomes in other countries that you know have greater problems with maternal morbidity and mortality, that the existence of COVID and pregnancy increases the risk for mom and baby,” said study lead 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 women 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 greater risk not only because they were pregnant, but also because they were immunologically naïve to the virus—they didn’t have any prior immunity to help them fight off 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 pregnant women in the US they had their primary series vaccines against Covid-19, and about 95% of Americans are evaluated that they got over Covid-19 at least once or were vaccinated against it, according to data from the Center 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% of pregnant women had an up-to-date vaccine, meaning many people may not have as much protection from the virus as they think they do.
Lead study author Emily Smith, who is an assistant professor of global health at George Washington University, says the study results reflect the risk of Covid-19 and pregnancy in unvaccinated people.
Unfortunately, Smith says, many countries still don’t have clear guidelines advising vaccination during pregnancy. And there are some parts of the world, like China, that still have significant proportions of the population that have 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 firmly to the vaccination side.
“It pays to protect yourself during pregnancy,” Smith said.
She says this study did not look at the benefits of vaccination in pregnancy, but other studies have, showing a large reduction in the risk of stillbirth, premature birth and serious illness or death of the mother.
“And it’s kind of a complementary story,” Smith said.
dr. Justin Lappen, director of maternal-fetal medicine at the Cleveland Clinic, praised the study and said its findings reinforce and advance previous research, which found that Covid-19 significantly increases the risk of severe outcomes for mother and baby. He was not involved in the study.
He says the findings highlight the importance of preventing and treating Covid-19 in pregnant women.
Therapies that are indicated or otherwise recommended should not be withheld specifically because of pregnancy or breastfeeding, Lappen wrote in an email to CNN.
The study was published in the journal BMJ Global Health.