[ad_1]
Pregnant women with COVID-19 are less likely to show the main symptoms of SARS-CoV-2 infection than non-pregnant women of similar age, according to research.
However, the study, published in The BMJ, found that they may be at higher risk of being admitted to a hospital intensive care unit.
Preterm birth rates were also found to be higher among pregnant women with COVID-19 than among pregnant women without the disease.
Pre-existing comorbidities were noted as important additional risk factors for severe COVID-19.
Review of the available evidence
Pregnant women are considered a high-risk group due to concerns about the effect of COVID-19 during and after pregnancy, and on their offspring.
To help understand the clinical implications for maternity services in the face of rapidly evolving evidence, a team of experts from the World Health Organization and the University of Birmingham analyzed data from 77 studies.
Most of the literature comes from the United States and China, but also includes studies from Italy, Spain, the United Kingdom, France, and eight other countries.
The studies reported rates, clinical characteristics, risk factors, and outcomes for 11,432 pregnant and newly pregnant women admitted to the hospital and diagnosed with suspected or confirmed COVID-19.
Overall, 10% of pregnant women and newly pregnant women who attended or were admitted to the hospital were diagnosed with COVID-19.
Compared with non-pregnant women, the pregnant and newly pregnant cohort were less likely to show symptoms of fever and myalgia.
They were also 62% more likely to need intensive care and 88% more likely to require invasive ventilation.
Increasing maternal age was a factor that increased risk, as were comorbidities that include higher BMI, hypertension, and diabetes.
Pregnant women with a pre-existing maternal comorbidity were more than four times more likely to be admitted to intensive care than women without pre-existing comorbidities.
The odds of giving birth prematurely were also higher in pregnant and newly pregnant women with COVID-19 compared to those without the disease.
A quarter of all babies born to mothers with COVID-19 were admitted to a neonatal unit and had an increased risk of admission compared to those born to mothers without the disease.
However, neonatal and stillbirth rates were low.
Study shows ‘need for greater awareness’
The researchers note some limitations of the study, including differences in study size, design, and definitions of symptoms, tests, and outcomes. However, they said they had taken a robust approach to ensuring that the data was robust.
Shakila Thangaratinam, professor of maternal and perinatal health at the University of Birmingham, who led the study, said: “Our study has demonstrated the need for greater awareness of health professionals about the symptoms and effects of COVID-19 in women. pregnant and recently pregnant women and early identification of pregnant women with risk factors.
“We will update our findings on a regular basis as new evidence emerges.”
Andrew Shennan, professor of obstetrics at King’s College London, praised the researchers for a comprehensive and well-conducted summary of the available evidence.
He told the Science Media Center: “It confirms that COVID-19 is not serious for the vast majority of pregnant women. Only 1 in 1000 affected women died and this is likely an overestimate as this data tends to inform increased risk for women and includes deaths from causes other than COVID-19.
“Preterm labor also does not increase, but early delivery may be necessary to help manage the sick woman. Pregnant women are slightly more likely to be admitted to intensive care.”
“Like people who are not pregnant, age, weight, high blood pressure and diabetes are important risk factors. Pregnant women were less likely to have a high fever and muscle aches, possibly because they were tested instead of presenting symptoms. “
Dr Edward Morris, President of the Royal College of Obstetricians and Gynecologists, commented: “This study highlights a possible increase in the need for intensive care among pregnant women with coronavirus.
“This is also true for pregnant women in case they contract the flu. This year, it is particularly important for pregnant women to accept the offer of the free flu vaccine, which is safe in all trimesters of pregnancy, to protect them. from severe illness with flu.
“The findings in this document highlight the need for more research on the effects of the virus on pregnant women and their babies so that health services better respond to their needs during this time.”
Clinical Manifestations, Risk Factors, and Maternal and Perinatal Outcomes of Coronavirus Disease 2019 in Pregnancy: Live Systematic Review and Meta-analysis, BMJ 2020; 370: m3320. Paper.
[ad_2]
