Pregnant Women at Higher Risk for Severe COVID-19: Get Vaccinated and Stay Up-to-Date
In the wake of the ongoing coronavirus disease 2019 (COVID-19) pandemic, pregnant women are more likely than the general population to develop severe COVID-19. Recent studies have reported an association between SARS-CoV-2 infection in pregnant women and increased rates of adverse neonatal and maternal outcomes relative to pregnant individuals without COVID-19. Vaccination has been identified as the best way to protect against severe COVID-19, and it is recommended that all persons who are eligible, especially those who are immunocompromised or have weakened immune systems, get an updated (bivalent) booster dose and stay up to date with their COVID-19 vaccines.
To better understand the effects of SARS-CoV-2 infection on pregnant women and their fetuses, Patric Kienast, M.D., from the Medical University of Vienna, and colleagues conducted a prospective case–control study wherein pregnant women who tested COVID-19-positive within seven days of hospitalization in any Italian maternity unit between January 1 and May 31 2022 were enrolled. Medical records were used to obtain data concerning pregnancy, delivery, and neonates.
When compared to pregnant women who were not infected, those with SARS-CoV-2 had a much higher risk of maternal mortality, admission to the ICU, being put on a ventilator, needing critical care, being diagnosed with pneumonia, and having thromboembolic disease (with respective relative risks of 7.68, 3.81, 15.23, 5.48, 23.46, and 5.50). The risk of a newborn baby of a mother infected with SARS-CoV-2 being admitted to a neonatal care unit, being born preterm or moderately preterm, and having a low birth weight were 1.86, 1.71, 2.92, and 1.19 times higher respectively. No correlation was observed between infection and stillbirth. The potential for bias was generally low to moderate.
In addition, the researchers used whole-transcriptomic digital spatial profiling of placentae to understand the mechanisms of SARS-CoV-2 pathogenesis in pregnancy. The livers and brains of three fetuses showed abnormal organs, suggesting that more vascular events may take place during the perinatal period in the brain.
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