June 22, 2021

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Pregnancy increases the risk of COVID-19 complications, according to a study

Pregnancy increases the risk of COVID-19 complications, according to a study

A study of more than 2,000 pregnant women from dozens of hospitals around the world found that those with COVID-19 saw a significantly higher risk of death and complications for themselves or their newborns.

The study, published Thursday in JAMA Pediatrics, points out that pregnancy is a major risk factor for complications involving COVID-19 – one that should be considered alongside obesity and asthma – and could help convince more women to line up for. vaccinations.

The new report adds to a growing body of evidence “which will hopefully tip the balance towards more people being vaccinated,” said Dr. Ilina Pluym, a maternal-fetal medicine specialist at UCLA who was not involved in the Research.

The COVID-19 pandemic has placed an additional burden on pregnant women: in addition to worrying about how they might be affected by a coronavirus infection, they are also concerned about the health of their babies.

This was especially true at the start of the pandemic, when the uncertain magnitude of the risks “was affecting the mental health of pregnant people,” the study authors wrote. This is largely due to the fact that there wasn’t much research available at the time to compare the results for pregnant women with and without COVID-19.

Dr Aris Papageorghiou, a specialist in fetal medicine at Oxford University, and his colleagues were able to begin monitoring pregnant COVID-19 patients at the onset of the pandemic, drawing on a network of hospitals involved in a large study. which monitors the health and development of normal pregnancies.

For eight months starting March 2, they enrolled women aged 18 and over at any stage of pregnancy or childbirth who had been diagnosed with COVID-19. Whenever they enrolled a new COVID-19 patient, they immediately enrolled two pregnant women without the condition who required the same level of care. If that wasn’t possible, they enrolled pregnant women who hadn’t been diagnosed with COVID-19 and gave birth immediately after the COVID-19 patient.

Eventually they enrolled 706 pregnant COVID-19 patients and 1424 pregnant women without the disease. The women were treated in 43 hospitals in 18 countries: Argentina, Brazil, Egypt, France, Ghana, India, Indonesia, Italy, Japan, Mexico, Nigeria, North Macedonia, Pakistan, Russia, Spain, Switzerland, the United Kingdom and the United States. United States. Most of the women were diagnosed during the third trimester of pregnancy.

Compared to pregnant women who did not have COVID-19, those who had it were 76% more likely to develop preeclampsia or eclampsia, the researchers found. They were also three times more likely to develop a serious infection that required treatment with antibiotics and five times more likely to be admitted to the hospital’s intensive care unit.

Surprisingly, the risk of death was more than 22 times higher for women with COVID-19.

Children were also disadvantaged. The risk of preterm delivery was 59% higher for mothers with COVID-19, and the risk of a medically indicated preterm delivery was nearly double. Compared to children who were not born to COVID-19 patients, those who had a 2.66 times greater risk of serious illness after birth and a 2.14 times greater risk of serious illness and death in the time immediately before and after birth .

For pregnant women, “it really appears that COVID increases the likelihood of having a negative outcome,” said Papageorghiou, senior author of the study.

Fever and shortness of breath – common symptoms of COVID-19 – have over a period of time been linked to a 2.56 times greater risk of serious complications for the mother and a 4.97 times greater risk of complications for the baby.

For pregnant women with coronavirus infections that didn’t cause COVID-19 symptoms, the picture wasn’t so grim: they had a 24 percent higher risk of disease and a 63 percent higher risk of preeclampsia.

Among women with coronavirus infections, 13% of their newborns also tested positive for the virus. Women who had a caesarean section were more than twice as likely to have a positive baby on the test. Breastfeeding, however, had no associated risks.

“This multinational study adds to that body of literature that all shows increased maternal morbidity,” said Dr. Laura Riley, a maternal-fetal medicine specialist at Weill Cornell Medicine who was not involved in the study.

The findings underscore the fact that pregnancy is indeed a risk factor for severe COVID-19 and should be treated as such, Papageorghiou said.

“You really need to try and avoid getting COVID during pregnancy,” she said. He went on to list some common strategies. “Isolate yourself more, wear your mask and your space and adhere to these kinds of general measures, or avoid COVID by getting vaccinated.”

Dr. C. Mary Healy, a pediatric infectious disease specialist at Baylor College of Medicine in Houston, said the biology of pregnancy can help explain why women may find themselves vulnerable to COVID-19.

Pregnancy is linked to a number of physiological changes, including increased heart rate and oxygen consumption, decreased lung capacity, and an increased risk of blood clots. And pregnancy “represents a natural state of immunosuppression,” she wrote in an editorial accompanying the study.

But he pointed out that most pregnancies in women with COVID-19 turn out to be OK.

“It is important to recognize that the absolute risks of severe COVID-19 for pregnant women are low,” she wrote.

Healy also noted that the high relative mortality rate reported in the study was based on pregnant COVID-19 patients who were concentrated in parts of the world “where resources were less readily available, particularly resources associated with intensive care practices.” .

Pluym praised the study’s size and global reach, adding that researchers should build on the findings by following mothers and babies to monitor the long-term effects of COVID-19. He also said more research should be done on the effects of COVID-19 on women in the first trimester of pregnancy.

“We have to keep studying it,” he said.