Pregnant women and their babies face unique challenges from covid-19, suggests new research published by the Centres for Disease Control and Prevention. The study found that pregnant women who develop covid-19-related symptoms while hospitalized often become critically ill, and pregnant women with covid-19 may be more likely to have a preterm birth or possibly even miscarriage.
The research, published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) on Wednesday, looked at the medical records of nearly 600 pregnant women between the ages of 18 and 45 with confirmed covid-19 who were hospitalized at some point between March and late August this year, via its existing surveillance network in hospitals across 14 states.
Among women with available medical information, most were initially hospitalized for other reasons than covid-19, predominantly related to their pregnancy or delivery. However, just under half developed symptoms of the viral infection. Of those with symptoms, 16% went on to need intensive care, 8% needed invasive mechanical ventilation, and two women died. As other research has suggested, there was a clear racial disparity, with Black and Hispanic women more likely to be hospitalized with covid-19 than other groups.
When it came to the pregnancy itself, about 12% of women with covid-19 had a premature delivery — higher than the 10% rate of preterm birth seen in the general population. The rate of preterm birth was even higher for symptomatic women, at 23%. Both symptomatic and asymptomatic women also experienced miscarriage, with a 2.2% rate overall. Two newborns died soon after birth, both delivered from women who were on invasive mechanical ventilation due to covid-19.
Early research had suggested pregnant women and their children weren’t especially at risk from covid-19, compared to the general public. But though it seems unlikely that the coronavirus is uniquely dangerous to a developing foetus in the same way as other viruses like Zika, more research has since pointed to a very real heightened risk of serious complications for pregnant women and their children.
A small study suggests that women who contract covid-19 while pregnant may be at higher risk for complications. Compared to uninfected women, women with covid-19 had a greater chance of injury to their placenta, the study found.Read more
That said, this study alone can’t directly show that pregnant women have more risk from covid-19 than others. But about one of every four women hospitalized with covid-19 in the sample was pregnant, among those with known information about their pregnancy status, further indicating that pregnancy can be an added risk factor for serious illness from covid-19. Premature newborns are themselves more at risk from other complications or serious illness should they catch covid-19, the authors noted (though transmission of the virus in the womb is considered unlikely, there have been reports of transmission after birth).
The CDC has since added pregnancy to a running list of known health conditions that may increase the risk of severe covid-19. And the authors suggest that added precautions be taken to keep pregnant women and their babies safe from the viral illness.
“These findings highlight the importance of preventing and identifying covid-19 in pregnant women. Pregnant women should avoid close contact with persons with confirmed or suspected covid-19, maintain 1.83 m of distance from non-household members, and take general covid-19 preventive measures, including wearing masks and practicing hand hygiene,” they wrote. “CDC recommends testing newborns born to mothers with COVID-19, isolation of mothers with COVID-19 and their newborns from other hospitalized mothers and newborns, and infection prevention measures for persons caring for newborns who might be exposed to SARS-CoV-2.”