It has been just over nine months since the first cases of COVID-19 were reported in Wuhan in December 2019, and thanks to the relentless work of the global scientific community we are learning numerous new traits of the novel coronavirus every other day. Now, the latest data from the US Centers for Disease Control and Prevention (CDC) and other health organisations suggest that pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes such as premature births or stillbirths.
Preterm birth due to COVID-19
Preterm or premature birth is when a baby is born too early, much before the completion of the usual 37-38 weeks of pregnancy. A full course of pregnancy is crucial for the complete development of different organs in a baby. Early deliveries, especially before 32 weeks, are proven to have higher rates of death and disability.
A study in the UK published in the reputed journal JAMA in July shows that the pandemic has led to high rates of preterm births and cesarean delivery among women with SARS-CoV-2 infection. The study also indicates that the stillbirths have also more than doubled compared to the national rate among infected women. Still, the study acknowledges that the sample size is too low to arrive at a conclusive inference.
Another study by the US CDC also shows that preterm deliveries occur in more than 15 per cent of 105 hospitalised pregnant with SARS-CoV-2 infection between March 1 and May 13. This rate is nearly 70 per cent higher than the baseline rates of preterm deliveries among non-infected women. Another study in New York also showed a preterm birth rate of almost 15 per cent among 241 women.
Factors affecting pregnant women
During pregnancy, the body’s immunity is suppressed to limit adverse reactions to the fetus. However, this natural response makes women vulnerable to infections. The CDC surveillance data also suggests that pregnant women might be at an increased risk for severe illness from COVID-19 compared to others. Therefore, health experts urge the utmost caution for pregnant women throughout pregnancy.
Other factors like obesity, sugar levels, pre-existing medical conditions and the immune response are also proven to have a link to COVID-19 severity. The study in New York also showed that obese women—especially with body mass index (BMI) 30 or higher—have a greater risk of severe COVID-19. A study in Maharashtra showed that more than 12 per cent of 1,140 pregnant women tested were positive for SARS-CoV-2 infection, demonstrating a substantial prevalence of the disease among pregnant women in India.
On a positive note, most of the studies quoted here consisted of the smallest sample size and involved only hospitalised pregnant women. Therefore, the results could be different when the entire population is considered. In some countries like Ireland and Denmark, the opposite is true, since preterm deliveries have reportedly declined during the pandemic.
“Based on what we know at this time, pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people. Additionally, pregnant people with COVID-19 may be at increased risk for other adverse outcomes, such as preterm birth. There is no way to ensure you have zero risks of infection, so it is important to understand the risks and know how to be as safe as possible,” says the CDC advisory.
For the latest coronavirus information in India and across the globe, and for other important resources, check out our dedicated COVID-19 page.