Covid in pregnancy increases the risk of maternal death

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Pregnant people infected with the coronavirus have a seven times higher risk of dying than pregnant people who aren’t infected, a finding that comes amid renewed calls for vaccinations from those expecting a baby.

The researchers, whose findings were published Monday in the journal BMJ Global Health, collected patient data from more than 13,000 pregnant women in 12 studies from 12 countries, including the United States. Along with a higher death rate, infected pregnant women had a higher risk of being admitted to an intensive care unit, needing a ventilator or developing pneumonia if they have a coronavirus infection.

Babies born to people with a coronavirus infection during pregnancy also had a higher risk of developing serious outcomes. They were twice as likely to need intensive care unit care after birth and had a higher risk of being born preterm.

Emily R. Smith, the study’s lead author and assistant professor of global health at the George Washington University Milken Institute School of Public Health, said vaccination rates for pregnant women are low likely because “the assumption is that if a person is pregnant, they are probably young and mostly healthy.

Overall pregnancy outcomes have improved over time, but this is not a neutral health event. The risk of health complications increases during pregnancy, even without a viral infection. And the coronavirus adds another layer of risk that could increase the chances of developing serious outcomes.

Being pregnant, even if a person has no underlying medical condition, puts them at a higher risk of developing serious illness if they are infected with the coronavirus.

While newborn death from coronavirus infection remains rare in the United States, babies born to someone with a coronavirus infection close to their due date had a 2 percent chance of testing positive for the virus in the first few days after birth, according to the American Academy of Pediatrics.

The implications for cognitive and physical developmental issues for an infant or young child remain unclear as research on the post-covid impact on this age group continues to develop.

This is why many health associations, such as the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, recommend the coronavirus vaccine for pregnant women. Despite the public health messages, the Centers for Disease Control and Prevention estimates that the number of people who received a coronavirus vaccine before and during pregnancy at any given time has decreased since 2021.

As of May 2022, according to a survey by the Kaiser Family Foundation, a non-profit health policy organization, about 29 percent of women who are pregnant or planning to become pregnant believed some form of misinformation about the coronavirus vaccine . Some of the unsubstantiated claims about the vaccine’s impact included effects on fertility and breastfeeding.

The survey found that while there is overall confidence in vaccines for adults, hesitancy can emerge when someone is about to have a child or is trying to get pregnant.

Kathryn Gray, a maternal-fetal medicine specialist at Brigham and Women’s Hospital in Boston, said misinformation about vaccines can be partly attributed to anti-vaccine rhetoric on social media.

“It’s become a political issue, and I think our health policy messaging hasn’t stayed at the level it should be,” Gray said. “People are still dying from it, and there are inadequate public health policy messages given the significant health consequences.”

Outside of pregnancy, overall global vaccination rates have declined and pandemic fatigue has gripped much of the world, causing the steep decline.

Despite mounting evidence that vaccines significantly reduce the risk of death and hospitalization from a SARS-CoV-2 infection, Smith said the push to vaccinate young people is a global concern and not an isolated one in the United States.

Jennifer L. Lighter, a pediatric infectious disease specialist at NYU Langone Health, added that there needs to be a more significant push in the healthcare community to get people vaccinated during pregnancy. “Some gynecologists and obstetricians are not prioritizing giving it,” she said.

Smith said she hopes this study will encourage more pregnant people to get the coronavirus vaccine.

“It’s not extreme advice here,” Smith said. “But it’s important to know that pregnant people are at a higher risk when they get covid, so it’s worth getting vaccinated and taking some of these precautions.”

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