American Crown and Pregnancy Study –

Last month, the U.S. Centers for Disease Control and Prevention (CDC) added pregnancy to the list of conditions that put people with corona at higher risk of developing serious diseases, including the risk of death. .

This was done on the basis of the new study conducted by the CDC.

It shows, among other things, that pregnant women who develop symptoms after corona infection have a 70 percent higher risk of death, compared to non-pregnant women with symptoms.

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Particular risk in the third quarter

In the study, the researchers examined the results of 409,462 symptomatic women, ages 15 to 44, who tested positive for COVID-19. 23,434 of them were pregnant.

The results show that pregnant women infected with corona have a higher risk of being admitted to the intensive care unit and of needing respiratory treatment than non-pregnant women of the same age group. The risk of death is also higher than for non-pregnant women.

The findings are supported by previous research in the area, according to assistant health director Espen Rostrup Nakstad.

– It is well known that pregnant women have a somewhat higher risk of severe disease progression into infectious diseases, especially in the third trimester, she tells Dagbladet.

He points out that overall there are very few women in the younger age groups who develop severe illness with COVID-19, although the risk is somewhat higher for pregnant women.

– Specifically, mortality from covid-19 in this study is estimated at 0.15 percent for pregnant women and 0.12 percent for non-pregnant women. When adjusted for age, ethnicity and underlying diseases, the “adjusted risk rate” for death is found to be 70 percent higher for pregnant women than for non-pregnant women, says the health director.

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There are no serious cases among pregnant women in Norway

The National Institute of Public Health currently has no plans to include pregnancy as a risk factor for serious disease in COVID-19 infection and believes that the CDC study is not directly transferable to Norwegian conditions.

One of the challenges in interpreting the results of this study is that other studies have shown that pregnant women do not have symptoms of COVID-19 more often than women who are not pregnant, explains Dr. Helena Niemi Eide of the Department of Control of the FHI Infections and Emergency Preparedness.

– When it does not include all pregnant women with covid-19, there is a risk that the sample is biased and this makes direct interpretation of the findings difficult, says Eide.

According to her, it is generally difficult to use studies from the US alone to assess the risk for pregnant women in this country. The health system is structured differently and there are different risks in the population.

“The United States has a higher incidence of death and life-threatening diseases in pregnant women and mothers than in other Western countries,” says Eide.

She notes that pregnant women in the Nordic countries and several other European countries are monitored more closely than in the United States. Results from the UK, among others, have shown that pregnant women can also become seriously ill, but not more so than non-pregnant women.

Preliminary results of the Norwegian monitoring show that so far no pregnant women with proven COVID-19 infection have required intensive treatment. There are also no deaths related to this in Norway.

Both Nakstad and Eide note that the risk for pregnant women is much lower than for risk groups designated by health authorities. Old age has been shown to be the main risk factor for serious illness, hospitalization and death.

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An international research group conducted a systematic review of relevant studies on the risk associated with COVID-19 among pregnant women earlier this fall. According to the FHI risk assessment, it was concluded that pregnant women with COVID-19 are at somewhat increased risk of severe illness, hospitalization, and the need for respiratory support.

The following findings were also highlighted:

• Pregnant women with COVID-19 experience symptoms less frequently, such as fever and muscle pain, than women who are not pregnant.
• The incidence of preterm delivery is probably higher among pregnant women with COVID-19, but this may be due to the fact that hospitals have established their own follow-up routines for pregnant women with COVID-19.
• A quarter of the newborns of mothers with COVID-19 detected were admitted to the neonatal intensive care unit. This figure is higher than for children born to mothers without COVID-19, but this may also be due to the fact that hospitals have established their own follow-up routines for children born to women with COVID-19.

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Risk group in various countries

Helena Niemi Eide of FHI says that several countries have defined pregnant women as a risk group, often out of a precautionary principle. Advice for pregnant women in Norway is to follow the general infection control advice, as well as contact the health service if necessary.

Pregnant women who have chronic illnesses or pregnancy complications can consult their GP if special care is necessary.

When it comes to vaccines, Eide explains that they are generally not tested in pregnant women until marketing authorizations are granted. This includes the Pfizer / BioNtech vaccine, which has been used in both the UK and the US.

– When test results are available in pregnant women, it may be relevant to recommend vaccines for pregnant women also in Norway. Evaluations on the use of the various corona vaccines for pregnant women can vary depending on the type of vaccine, Eide says.