A new study in a hospital in the ultra-Orthodox Israeli city of Bnei Brak found a significantly increased risk of poorer outcomes for the newborns and symptomatic women with COVID-19 – adding further weight to the argument for pregnant women to be vaccinated against Coronavirus.
Assessing 2,471 women soon before their delivery, the researchers found “significant differences” in symptomatic Covid-positive patients, including higher rates of gestational diabetes (which presents a high risk of developing type 2 diabetes later in life), lower white-blood-cell counts, and heavier bleeding during delivery, along with respiratory complications in their babies.
The most common symptom was a cough, from which half of the women suffered. Fortunately, in the group of patients – which included 172 COVID-positive women (56 of whom were symptomatic) – monitored at the Ma’ayanei Hayeshua Medical Center, only one woman needed mechanical ventilation, and there were no maternal deaths.
The peer-reviewed findings have just been published in The Journal of Maternal-Fetal & Neonatal Medicine under the title “Does the presence of symptoms affect pregnancy outcomes in women with SARS-CoV-2 infection in third trimester?”
The answer to the questions is “Yes!” according to lead author Dr. Elior Eliasi. COVID-19 in the third trimester of pregnancy “has clinical implications, albeit at lower rates than expected once asymptomatic patients are taken into account.” The Bnei Brak obstetrician/gynecologist declared: “Our findings support the importance of vaccinating all pregnant women at all stages of pregnancy.
Pregnant women are known to be disproportionately affected by respiratory illnesses, which are frequently linked with increased risk of infectious and high maternal death rates, wrote the researchers. “Due to physiologic maternal adaptations affecting the immune, coagulation and cardiopulmonary systems, among others, there may be an increased risk of severe maternal illness following infection with respiratory viruses.”
While most human Coronavirus infections are mild, the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) epidemics during the past two decades have resulted in deaths, with about one-quarter of infected women in labor dying from these infections. Beyond the impact on the pregnant woman, there are concerns regarding the effect of maternal respiratory dysfunction in COVID-19 on the fetus, they wrote, and the direct effect of the virus on the fetus by vertical transmission.
The analysis found no major increase in cesarean delivery in women who were COVID-19 positive, and the incidence of preterm deliveries was not significantly different among the three groups (healthy; asymptomatic COVID-positive; and COVID-positive patients with symptoms). Most pregnancy and delivery outcomes were similar between COVID-19-positive and -negative woman in labor about to give birth.
“However, there were significant differences between the COVID-19-positive and healthy controls included higher rates of gestational diabetes, low white-blood-cell counts, bleeding during birth and respiratory complications in the newborns.”
The study looked at births at the hospital between March 26 and September 30, 2020. A total of 93% of women admitted to the delivery ward during this period were negative for COVID-19. Of the COVID-19-positive patients, 67% were without symptoms of the potentially dangerous viral infection.
On average, the increase risk of incidence of adverse outcomes was 13.8% higher for asymptomatic covid patients and 19.6% higher for those with symptoms
“More data are now needed to better delineate the differences between pregnancy outcomes seen in certain populations, potentially related to different viral characteristics (subtypes or viral load) or other factors,” the authors stated.
“Additionally, the effects of maternal infection on the fetus both in terms of symptomatic maternal illness and vertical viral transmission [from mother to baby] remain to be further investigated.”