Covid during pregnancy increases risk of maternal death

Pregnant women infected with SARS-CoV-2 run a seven times greater risk of death than those who do not contract the virus and are more likely to be admitted to intensive care, according to a study that highlights the importance of vaccination against covid-19 for all women of reproductive age.

These are two of the conclusions of a meta-analysis with data from 12 studies from 12 countries, including Spain and the United States, in which 13,136 women participated. The results, which also show increased risks for babies, were published in BMJ Global Health.

“This study provides the most comprehensive evidence to date to suggest that Covid-19 is a threat during pregnancy,” summarizes Emily R. Smith of the Milken Institute at George Washington University and lead author of the study.

This is a meta-analysis with data from 12 studies from 12 countries, including Spain and the United States, in which 13,136 women participated.

“Our findings -he adds- underline the importance of vaccination against covid-19 for all women of reproductive age.” Despite growing knowledge about the risks of this disease during pregnancy, many women of reproductive age remain unvaccinated.

In some cases, they hesitate or refuse to receive the vaccine or booster dose because they do not believe that covid-19 poses risks or because they are not convinced of its safety during pregnancy, recalls a note from the American university. Some doctors might even be hesitant to administer the vaccine to a pregnant woman, even if it’s recommended, says Smith.

Researchers examined data from pregnant women in Ghana, China-Hong Kong, Italy, Kenya, Nigeria, South Africa, Spain, Sweden, Democratic Republic of Congo, Turkey, Uganda, and the United States.

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They found that, compared with uninfected pregnant women, pregnant women with COVID-19 infection had a seven times greater risk of dying during pregnancy or childbirth and a nearly four times greater risk of being admitted to the intensive care unit.

In relation to thromboembolic disease or blood clots, the danger is more than five times greater

Also, a 15 times greater risk of needing ventilator treatment and 23 times more likely to develop pneumonia.

For thromboembolic diseases, or blood clots, which can cause pain, swelling or other life-threatening complications, the danger is more than five times greater.

More neonatal care

Babies born to women with COVID-19 infection were almost twice as likely to be admitted to a neonatal care unit; almost three times more likely to be born moderately premature (before 34 weeks); and 19% more likely to have low birth weight.

But, contrary to the results of previous analyses, infection with covid-19 was not associated with an increased risk of stillbirth at 28 weeks of pregnancy or more, nor with restricted growth.

According to Smith, despite the very serious health risks, more than 80 countries still do not recommend that all pregnant and breastfeeding women receive the vaccine against covid: “All countries, including the United States, must make access to vaccines against covid an urgent priority to save lives and prevent health problems”.

The research was funded by the Bill and Melinda Gates Foundation.

Reference:

Emily R Smith et al. “Adverse maternal, fetal, and neonatal outcomes among pregnant women with SARS-CoV-2 infection: a meta-analysis of single participant data”. BMJ Global Health (January 2023)

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