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Coronavirus

How dangerous is COVID-19 for pregnant women? Experts weigh in

Published: Updated:

Expectant mothers are not only at an increased risk of developing severe cases of COVID-19, but - in some instances - they have a 70 percent higher risk of death when compared with nonpregnant women, according to research by the Centers for Disease Control and Prevention.

CDC released the findings in two Morbidity and Mortality Weekly Reports.

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For the first report, researchers reviewed data on 1,300,938 women ages 15 to 44 who tested positive for the coronavirus during the period spanning January 22, 2020, to October 3, 2020.

The pregnancy status was known for 461,825 of the women, and 409,462 of the women for whom pregnancy status was known experienced symptoms of COVID-19. According to the report, 23,434 of those symptomatic women were pregnant.

According to the researchers, 34 of the pregnant women who experienced symptoms of COVID-19 died, with a rate of 1.5 per 1,000 cases. In comparison, 447 of the 386,028 nonpregnant women who experienced symptoms of COVID-19 died, with a rate of 1.2 per 1,000 cases. According to the researchers, the difference represents a 70 percent increased risk of death among pregnant women with COVID-19 symptoms when compared with nonpregnant symptomatic women.

The researchers also found that pregnant women with COVID-19 symptoms were more likely to require invasive ventilation than nonpregnant symptomatic women and were also at an increased risk of requiring treatment with extracorporeal membrane oxygenation (ECMO), a heart-lung bypass machine.

According to the study, symptomatic pregnant women’s increased risk of severe COVID -19 could be related to the physical changes that occur during pregnancy, “including increased heart rate and oxygen consumption, decreased lung capacity, a shift away from cell-mediated immunity, and increased risk for thromboembolic disease.”

Aubrie Cusumano, who is 39 weeks pregnant, receives the Pfizer-BioNTech vaccine against the coronavirus disease (COVID-19) while holding her son, Luca's hand at Skippack Pharmacy in Schwenksville, Pennsylvania, US, February 11, 2021. (Reuters)
Aubrie Cusumano, who is 39 weeks pregnant, receives the Pfizer-BioNTech vaccine against the coronavirus disease (COVID-19) while holding her son, Luca's hand at Skippack Pharmacy in Schwenksville, Pennsylvania, US, February 11, 2021. (Reuters)

For the second report, researchers looked at a sample of 3,912 live births among women who tested positive for the novel coronavirus that occurred during the period spanning March 29 to October 14, 2021. The researchers found that 12.9 percent of those delivers occurred preterm, which is higher than the national rate of 10.2 percent among the general US population. According to the researchers, frequency of preterm birth did not have any associations with whether the pregnant women had experienced symptoms of COVID -19.

COVID-19 pregnant deaths

Cases of COVID-19 pregnant deaths have also been reported across the globe.

In Brazil, COVID-19 has critically affected expectant mothers, with more than 1,000 deaths, according to local statistics, reported in the BBC.

One in five women that died from the virus didn’t have access to an intensive care unit and one in three didn’t have access to a ventilator.

So far Brazil has recorded more than 530,000 coronavirus related deaths and only 45 percent of the population has received at least one dose of the vaccine.

In India. doctors at the Government Institute of Medical Sciences, also known as the G.I.M.S., a public hospital in Noida, a suburb of Delhi, told the Washington Post that during first wave of COVID-19 last year, most pregnant women had moderate symptoms and were able to return home after being hospitalized for a few days.

However, in 2021, amid more severe variants of the disease, this has changed.

Throughout March, April and May in 2021, the doctors said that most pregnant women arrived with acute respiratory distress syndrome, their lungs collapsing. one was recovering.

Pregnant women, who have weaker immune systems, have been developing widespread scarring of the lungs after getting infected by the virus. “Their lungs looked white as bone on X-rays,” the doctor said. “Their air sacs filled with fluid that had leaked from blood vessels into the lungs.”

With a more severe second wave of COVID-19 since mid-February, Indian doctors started observing a greater need for high oxygen ventilation for pregnant women, a need for more surgeries to expedite and prematurely deliver babies, and a higher incidence of abortions and stillbirths.

A pregnant woman receives a vaccine for the coronavirus disease (COVID-19) at Skippack Pharmacy in Schwenksville, Pennsylvania, U.S., February 11, 2021. (Reuters)
A pregnant woman receives a vaccine for the coronavirus disease (COVID-19) at Skippack Pharmacy in Schwenksville, Pennsylvania, U.S., February 11, 2021. (Reuters)

Countries including the US, Britain and Belgium have now begun prioritizing expectant mothers for vaccination. But Indian women are not yet permitted to get the COVID-19 vaccine because Indian authorities have cited a lack of empirical data supporting the urgency of inoculating them.

In the Gulf, Dubai announced plans to start vaccinating pregnant women against COVID-19 in June.The Dubai Health Authority (DHA) stated that pregnant women will be able to take the vaccine after the first 13 weeks of pregnancy and can pre-register and book an appointment on the DHA app or via DHA’s WhatsApp service.

It follows similar moves by Saudi Arabia. In April, the Kingdom’s Ministry of Health announced pregnant women can now register to take the coronavirus vaccine, days after one of the largest reports on COVID-19 vaccination in pregnancy published evidence that the dose is safe for pregnant women.

Sascha Ellington, a health scientist and one of the authors of the first CDC report, explained the results from the data.

“Previously [CDC] said [pregnant women] ‘might be’ at increased risk for severe illness” from COVID -19. However, CDC is “now saying pregnant women are at increased risk for severe illness,” Ellington said.

Ellington emphasized that the overall risk among pregnant women with COVID -19 for both complications and death was low, “but what we do see is an increased risk associated with pregnancy.”

Denise Jamieson, chair of gynecology and obstetrics at Emory University School of Medicine, said the reports emphasize how important it is for pregnant women to avoid exposure to the novel coronavirus.

“This is new information that adds to the growing body of evidence, and really underscores the importance of pregnant women protecting themselves from COVID,” Jamieson said. “It’s important that they wear a mask and avoid people who are not wearing a mask.”

Read more:

Pregnant women in Saudi Arabia can take COVID-19 vaccine: Health Ministry

Dubai begins Pfizer COVID-19 vaccinations for pregnant women

Brazil halts COVID-19 vaccination of pregnant women after a death in Rio de Janeiro