Infectious Disease

Pregnant women with COVID-19 are at higher risk of premature birth

August 13, 2021

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Women diagnosed with COVID-19 during pregnancy, especially those with other comorbidities, were at higher risk of very premature births, premature births, and premature births, a population-based study showed.

The study in The Lancet Regional Health – Americas is the first of its kind, according to a press release, large enough to identify the risks for COVID-19 by specific subtypes of premature birth, as well as by race, ethnicity, and insurance status.

Reference: Karasek D, et al. Lancet Regional Health-Americas. 2021; doi.org/10.1016/j.lana.2021.100027.

Deborah Karasek, PhD, an assistant professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco, and colleagues analyzed data from 204,157 live births in California between July 2020 and January 2021. Of the mothers, 8,957 had a diagnosis of COVID-19 during pregnancy.

The researchers wrote that they used the “best obstetric estimate of gestational age” to predict births as either very early (less than 32 weeks), early (less than 37 weeks), early (between 37 and 38 weeks), or on time ( between) to be marked 39 and 44 weeks).

They found that underrepresented groups had a “disproportionate burden” from COVID-19 infections. For example, among women who gave birth in January, 12.9% of Native American / Alaskan women, 11.4% of Indigenous Hawaiian / Pacific Islander women, 10.3% of Latinx Women and 5.7% of non-Latin black women diagnosed with COVID-19 during pregnancy compared to 4.6% of white non-Latinx women and 3.8% of Asian women. “Latinx” is a gender-neutral alternative to Latino or Latina.

Karasek and colleagues reported that a COVID-19 diagnosis associated with an increased risk of very premature births (adjusted RR = 1.6; 95% CI 1.4-1.9), premature birth (aRR = 1.4; 95% -KI 1.3 to 1.4). and premature birth (aRR = 1.1; 95% CI, 1.1-1.2). The overall risk remained the same regardless of race / ethnicity or insurance status. However, women diagnosed with COVID-19 and diagnosed with high blood pressure, diabetes or obesity had a 100% higher risk of premature birth and a 160% higher risk of very premature birth compared to women without a COVID-19 diagnosis or comorbidities, so the message.

“Given that the burden of COVID-19 is greater in these populations, as is the burden of preterm birth, this really indicates the need for an equitable approach,” Karasek said in the press release. “With the rise in infections and the rise in the delta variant, we must think of pregnant people, especially black and brown populations, as groups to be prioritized, with supportive measures to reduce exposure and stress and improve access to medical care Care. ”

The study results also underscore the importance of vaccination in pregnant women, said Karasek.

Both the American College of Obstetricians and Gynecologists and the CDC recommend that pregnant women get the COVID-19 vaccine. Recently, the CDC reiterated its recommendation, citing data from an analysis of nearly 2,500 pregnant women that showed that the COVID-19 mRNA vaccine did not increase the risk of miscarriage before the 20th week of pregnancy. Even so, according to the agency, only about 23% of pregnant women in the US have received at least one dose of a COVID-19 vaccine.

Karasek recommended that health professionals and pregnant women have two-way discussions about COVID-19 vaccination.

“Pregnant women may have concerns about vaccines and their baby’s health. Therefore, it is vital to have an open dialogue that values ​​these concerns, describes evidence of safety and communicates the risks of COVID-19 infection during pregnancy, ”she said in the press release.

References:

American College of Obstetricians and Gynecologists. Considerations for COVID-19 vaccination for obstetric and gynecological care. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care. Accessed August 12, 2021.

CDC. COVID-19 data tracker. https://covid.cdc.gov/covid-data-tracker/#vaccinations-pregnant-women. Accessed August 13, 2021.

Fernandez, E. COVID-19 during pregnancy in the context of premature birth. https://www.ucsf.edu/news/2021/08/421181/covid-19-during-pregnancy-associated-preterm-birth. Accessed August 12, 2021.

D. Karasek et al. Lancet Regional Health-Americas. 2021; doi.org/10.1016/j.lana.2021.100027.

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