New research findings published today in the BMJ helps to shed light on the risks of COVID-19 for pregnant women and their babies. The paper suggests that pregnant women seen at the hospital with suspected or confirmed COVID-19 are less likely to experience a fever or muscle pain, but if they develop severe disease they are more likely to need intensive care than non-pregnant women with COVID-19.
This is first paper of a 'living systematic review'; ongoing, global, research which is collecting and synthesizing data on the situation for pregnant women with COVID-19 in countries worldwide. It has been led by researchers at the University of Birmingham, UK, the World Health Organization, and the Special Programme HRP alongside other collaborators.
Pre-existing medical conditions
Evidence currently suggests that people who are non-white, are older, who are overweight and/or have a pre-existing medical condition, are more vulnerable to severe disease due to COVID-19. According to the findings published today, pregnant women with COVID-19, who have pre-existing medical conditions, such as diabetes or chronic high blood pressure, or those who are older or overweight, are also more likely to suffer severe health complications due to COVID-19.
The evidence shows us that having pre-existing health conditions such as diabetes or high blood pressure, puts you at greater risk, whether or not you are pregnant."
Mercedes Bonet, Study Author
These findings underline the need for pregnant women and recently pregnant women to take all precautions to avoid COVID-19 disease, in particular if they have underlying conditions.
Risks for newborn babies and women
The research findings show that pregnant or recently pregnant women with COVID-19 were more likely to give birth prematurely. The findings also show that 1 in 4 of all babies born to women with COVID-19, were admitted to a neonatal unit but data on causes of preterm births or indications for admission to neonatal units among these babies is lacking. Stillbirth and newborn death rates however were low.
Implications for healthcare
It is important healthcare providers are aware that pregnant women with COVID-19 and their newborn babies may be more likely to need specialist care, and that women and their babies have access to this care. This is particularly true for pregnant women with COVID-19 alongside other co-morbidities.
In addition it is crucial to stress that whether or not a woman has COVID-19, her right to a positive pregnancy and childbirth experience must be ensured. Read more
It is also important to recognize the increased stress and anxiety caused by COVID-19 which may be particularly felt by pregnant women, recently-pregnant women, and their partners, children, and families; healthcare providers have a role in responding to pregnant women in an appropriate and compassionate way.
Allotey, J., et al. (2020) Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. doi.org/10.1136/bmj.m3320.