Severe COVID-19 infection associated with increased risk of stillbirth and preterm birth

New data from the Montreal-Canada study correlate COVID-19 with an increased risk of pregnancy complications such as preterm birth and stillbirth, with increased risk in severe infections.

Researchers in Montreal conducted a meta-analysis of 42 studies of 438,548 pregnant women worldwide.

The data, including Dr. Nathalie Auger of the University of Montreal School of Public Health, provide clear evidence that symptomatic or severe COVID-19 is associated with a significant risk of preeclampsia, preterm birth, and low birth weight. I will do it. “

“Clinicians need to be aware of these adverse consequences in managing COVID-19-affected pregnancies and adopt effective strategies to prevent or mitigate risk to patients and the foetation. “The study published Friday in the Canadian Medical Association Journal concludes.

According to this study, COVID-19 patients were more likely to experience preeclampsia, a condition that causes high blood pressure in stillbirth, preterm birth, and late pregnancy, than patients without the disease.

Compared to asymptomatic patients, symptomatic patients had a double risk of preterm birth and a 50% increased risk of caesarean section.

Patients with severe COVID-19, on the other hand, were four times more at risk of experiencing hypertension and preterm birth than patients with mild cases.

The reason for the increased risk is unknown, but researchers say it may be because the virus that causes COVID-19 stimulates an inflammatory response that affects blood vessels.

“The lack of knowledge about SARS-CoV-2 infection during pregnancy raises urgent questions between obstetricians and neonatal scientists about the risk of maternal, fetal and neonatal morbidity and mortality,” the study said. Stated.

“There is an urgent need for evidence to guide clinical decisions.”

Dr. Deborah Money, an obstetrician who leads a national surveillance project on pregnancy during a pandemic, said the findings of pre-eclampsia were surprising in a newly published study.

“They made some suggestions related to information related to the acquisition of COVID-19, which may affect the placenta, but said that there was one different meta-analysis in the whole international literature. I think, said Money, a professor of obstetrics and gynecology at the University of British Columbia.

“Since we have analyzed 1,800 pregnant COVID cases in Canada so far, we are all scanning, monitoring and looking for adverse results that were not necessarily expected due to this fairly rare infection. It’s solid and robust, “she said of obstetricians and gynecologists around the world.

Canadian findings have already shown that pregnant women with COVID-19 are at increased risk of hospitalization and preterm birth, but previous data do not show whether stillbirths are statistically high.

Money said some aspects of the Montreal study felt problematic because they included women who were suspected and proven to be infected with COVID-19. It is also based on a diverse group of international studies, including parts of the world that have challenges in providing prenatal care where baseline rates of pregnancy outcomes will vary.

“We see some disturbing literature from Mexico and South America, which we believe is related to the social determinants of care and access to health care,” she says. I did.

Pregnant women need to take all precautions and consider getting vaccinated to reduce interactions outside the family bubble, Money said.

“The message I want to send is that it is very important for women to have access to health care when needed. Mr. Money is taking public health precautions to protect his patients. He said that in clinics and hospitals, symptoms such as high blood pressure appear.

— By Cassandra Szklarski in Toronto and Camille Bains in Vancouver

This report by The Canadian Press was first published on March 19, 2021.