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What you need to know about Covid-19 and pregnancy

 


Doctors know that the virus can cause complications during pregnancy and are currently competing to understand the effects of Covid-19. There is evidence of risk so far, but it may not be as serious as the complications of influenza and some other viruses.

Pregnant women are more vulnerable to infections due to factors such as changes in the immune system and respiratory system during pregnancy. “The big risk during pregnancy isn’t as dramatic as other respiratory illnesses like the flu,” says Dennis Jamison, chair of the Gynecology and Obstetrics Department at Emory University School of Medicine in Atlanta. But experts say, given how the virus affects people differently, more and longer-term research is needed to understand the effects of the virus on this population.

A new study of the effects of the virus on pregnant women and their babies also reveals both reassurance and alarming findings regarding the effects on mothers and children. Two recently published studies from the National Register at the University of California, San Francisco and the University of California, Los Angeles show that Covid-19 mothers appear to have prolonged illness attacks, but are primarily healthy babies. Is giving birth.

According to a study by the Centers for Disease Control and Prevention, women hospitalized with Covid-19 can develop serious illnesses, premature births, miscarriages and stillbirths. (This study did not measure whether the virus increased the risk of these developments in mothers because there was no control group for pregnant women without Covid-19.) Other studies have found Covid-19 mothers. I know the preterm birth rate. It’s not higher than the one without the virus.

Many pregnant women are worried about the virus and its unknown effects. “There are so many unknowns that test positive for Covid during pregnancy,” says Melinda Castillo, a 39-year-old financial analyst in Texas, who was tested positive for Covid-19 in August. December boy.

Questions remain, especially as to how the coronavirus affects women in early pregnancy. Another UCSF study enrolls 10,000 women to see if infection with the virus in the first semester can affect their 18-month-old neurological development.UCSF / UCLA study published last week Obstetrics and gynecology It was found that 25% of 594 pregnant women with Covid-19 had symptoms for more than 2 months. The median time to resolution was 37 days. Mrs. Castillo, who participates in the study, says she feels better after about five weeks.

“When using Covid, the course of illness in pregnant people can be quite long,” said UCSF’s Vice-Chair of Research in Obstetrics and Gynecology and Reproductive Sciences, co-leader of the study. Said Vanessa Jacoby.

The findings are part of the Pregnancy Coronavirus Outcomes Registry, referred to by the acronym Priority. This is a UCSF / UCLA study of 1,300 pregnant or postpartum women with confirmed or suspected cases of Covid-19.

“Previous influenza outbreaks have made the course of illness in pregnant women much worse,” said Dr. Jacoby, referring to H1N1 swine flu and SARS. “So we felt this very urgent need to provide information about Covid-19 and pregnancy.”

previous Priority research Of the approximately 179 babies born to Covid-19 women, it was found that they had few poor health compared to 84 mothers who did not carry the virus. However, unless women infected with Covid-19 have a high NICU hospitalization rate of up to two. A few weeks before delivery. The study found that only 1% of babies born to Covid-19 mothers were virus-positive and did not appear to affect the virus.

However, two recent studies from the US Centers for Disease Control and Prevention have more calm news. They found that hospitalized pregnant women infected with the coronavirus could develop serious health complications, prematurely give birth to babies, and miscarriage or stillbirth.

Experts warn that the study may not fully capture the problem, as researchers only looked at women who had Covid-19 and did not compare it to pregnant women who did not have Covid-19. I will.

The· Research included When nearly 600 pregnant women in Covid-19 were hospitalized for a variety of reasons, more than half of them were asymptomatic. Of the 272 symptoms, 8% needed mechanical ventilation for respiratory support and 16% were admitted to the intensive care unit. About 2% of women have a miscarriage. Two mothers died during hospitalization and two newborns died in the hospital after giving birth.

Approximately 23% of symptomatic women had preterm births, while 12.6% of all women in this study, including asymptomatic women, had preterm births. The preterm birth rate in the United States is 10%. Latest CDC data..

Recent studies have focused on women in late pregnancy. Marcelle Cedars, a professor and director of reproductive endocrinology and infertility at the University of California, San Francisco, is leading a study called Aspire to assess the safety of pregnancy in a coronavirus pandemic. This initiative aims to enroll women early in pregnancy and follow them until childbirth and until the baby is 18 months old.

“This is the time of greatest risk of pregnancy,” says Dr. Cedars. “This is a particularly important time for brain development.” The researchers enrolled more than 1,000 of the expected 10,000 women. They compare the results of mothers infected with Covid-19 and those who are not, and examine the difference between asymptomatic and symptomatic infections.

Studies have shown that the virus that causes Covid-19 rarely crosses the placenta, but it can still cause inflammation of the placenta, putting risks to pregnancy and children, Dr. Cedars said. I will. Studies of other viruses have shown that inflammation in early pregnancy can affect the neurological development of babies.

Initiating an immune response can cause inflammation and can affect asymptomatic women. “If the immune response begins, the mother may not be physically ill, but the baby may still have downstream effects,” says Dr. Cedars.

The effects may not appear at birth, but early on they may appear in subtle neurological and developmental problems such as autism, says Dr. Cedars. “The first time we see these changes is about 18 months,” she says.

Laura Johnson, Hickory, NC, is participating in the Aspire study and is scheduled for March. Johnson, 33, tested positive for Covid-19 in August. For about six days, she felt congestion and pain in her body and lost her sense of smell.

“I had a relatively mild case,” she says. “But in terms of pregnancy, I was afraid. It wasn’t like the level of illness that scared me. Nobody wants to call their doctor and let them say” I don’t know. ” There is none. They were as reassured as possible, but the information is constantly changing. “

Write to Sumathi Reddy at [email protected]

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