COVID-19 and pregnancy: new research warns virus increases risks of complications during delivery

Women who have COVID-19 during childbirth are more likely to face complications than future moms without coronavirus, researchers say. Fortunately, the absolute risk of complications for any woman is very low (less than 1%). But the relative risks of problems, such as clotting and preterm birth, are significant, based on a new study.

Still, “the findings here are that Among women who are hospitalized for childbirth and diagnosed with COVID-19, adverse events are incredibly low. That should provide a lot of reassurance for women who are expecting to become pregnant during this period, or who are pregnant, “said study co-author Dr. Karola Jering, of the cardiovascular medicine division of the Brigham and Women’s Hospital en Boston.

Over eight months in 2020, she and her colleagues collected data on more than 400,000 expectant mothers, of whom nearly 6,400 were infected with COVID-19. Among COVID-19 patients, researchers found that the relative risk of developing any type of blood clot was almost five times higher than for those without the virus, and almost four times higher for venous thromboembolism, clots in the veins.

These women were also much more likely to need intensive care or a respirator, the researchers found. Infected women were 7% more likely to need a cesarean section, 19% more likely to have preterm labor, 17% more likely to have preterm labor, and 21% more likely to have pre-eclampsia. “A pregnant woman can do little to reduce these risks beyond not being infected ”, said Jering.

“The problem, of course, is that right now most of us have supportive care for patients with COVID-19, in general. AND of the things that have been tested for treating COVID-19 patients, most of them have not been tested on pregnant women. ” the doctor warned Scott Solomon, co-author of the study and also of Brigham and Women’s.

But Jering She said pregnant women are given the other medications that are often given to COVID-19 patients, including blood thinners to prevent clots.

“In summary, the study findings were positive”, he emphasized Jering. Among pregnant women with COVID-19 who gave birth, 99% were discharged, 3% required intensive care and 1% required mechanical ventilation. Less than 1% died in the hospital.

For the expert, these findings should reassure women who have COVID-19. And although complications can occur, most women will have a normal pregnancy and delivery.

In dialogue with the scientific journal WebMD, the doctor Eran Bornstein, Vice President of Obstetrics and Gynecology at Lenox Hill Hospital in New York City, stated: “Overall, These findings are important because they provide further support for previous observations regarding COVID-19 risk factors during pregnancy. as well as pregnancy complications ”.

Coronavirus, pregnancy and vaccination

“Finally, we have some solid data on the risks of COVID-19 during pregnancy. Y lor we needed now more than ever, since women who are pregnant or who are thinking about getting pregnant will have to make decisions as to whether or not to receive a vaccine that was evaluated in studies that specifically excluded pregnant women, ”he warns F. Perry Wilson, associate professor of medicine at the Faculty of Medicine of the Yale University.

In a special section of Medscape, the website that provides access to medical information for physicians, Wilson ensures that “this document shows that COVID-19 has some quite significant effects on pregnancy, and we must take those risks into account when considering whether to recommend vaccination. “

“In that context, What do we know about the risks and benefits of vaccination in pregnant women? Not much. They were excluded from the major clinical trials that led to current vaccine approvals in the United States, for example. Some women became pregnant during their participation in the Pfizer and Moderna trials, but the vast majority of the results are unknown, presumably because these women are still pregnant. There are no red flags, but obviously there is not much data to continue ”, holds the specialist.

And he concludes: “There is not much reason to think, biologically, that mRNA vaccines would lead to adverse pregnancy outcomes, but that may not be reassuring for many women. For many women, the vaccine will better balance its risk and benefit assessment. For others, greater vigilance in hand hygiene, wearing masks, and avoiding crowds may be the best option to mitigate risk. One thing is clear: if you can avoid COVID during pregnancy, you probably should. “

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