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COVID-19 and Pregnancies

 How Does COVID-19 Affect Pregnancies?

    From January-September 2020, the coronavirus has infected millions of Americans including over 20,000 pregnant women according to the Centers for Disease Control and Prevention. How does COVID-19 affect these pregnant women and their babies? Can the coronavirus be passed on from an infected mother to her child? A study published on September 25, 2020 in the Journal of Prenatal Medicine took the data of 388 COVID-19 pregnancies in 22 different countries and analyzed the effects of the virus on the pregnant mothers and their children. 

    Below is a list of definitions of various fetal outcomes. These terms are brought up in the original study and this post. 

  • Gestation: time between conception and birth
  • Stillbirth: death of a fetus after 22 weeks of gestation which occurs before or during delivery
  • Neonatal death: death of a live-born infant within the first 28 days of life
  • Perinatal death: Stillbirth or neonatal death

Results and Effects on Mothers

    Out of the 388 pregnant mothers with COVID-19, 8% were diagnosed with COVID-19 during their first trimester of pregnancy, 22% in the second, and 68.9% in the third. There were three maternal deaths, accounting for a total maternal mortality rate of 0.8%. Although the maternal mortality rate was relatively low, 11.1% of the pregnant mothers were admitted to an intensive care unit (ICU) and 6.4% required intubation. The study also found that maternal need for oxygen was significantly associated with poor fetal outcomes. 

Results and Effects on Children

    The adverse outcomes from the study included miscarriages, stillbirths, and neonatal deaths from the study group. These deaths accounted for an overall perinatal mortality rate 4.1%. However, it was noticed that the "incidence of poor fetal outcomes was significantly higher when COVID-19 infection occurred in the first 3 months of pregnancy," says Dr. Cihat Sen, an author and researcher of the study. Of the 250 live born infants, only 1 child tested positive for COVID-19 after delivery. The mother was tested positive during her third trimester of pregnancy. However, the newborn child was asymptomatic and tested negative for the virus after 2 weeks. Thankfully, these results suggest that COVID-19 transmission from a mother to a child is very rare and if transmitted, the child is not severely affected. 

Summary and Implications

    Findings from the study showed that women associated with COVID-19 during pregnancy have a low mortality rate (0.8%), but an 11.1% rate of admission to the ICU. Additionally, diagnosis of COVID-19 during the first trimester of pregnancy and maternal need for ventilation were factors associated with adverse fetal outcome. The child mortality rate was around 4%, mainly related to premature births. Finally, the risk of COVID-19 transmission from mother to child was very small, with a rate of 0.4% .
    The results suggest that minimizing risk of infection in mothers during the early stages of pregnancy may significantly decrease chances of perinatal death. The study also found that it's unlikely for COVID-19 to be transmitted from an infected mother to her child. 

Sources

  1. Di Mascio, D., et al. (2020) Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. Journal of Perinatal Medicine. doi.org/10.1515/jpm-2020-0355. 
  2. “Data on COVID-19 during Pregnancy.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/coronavirus/2019-ncov/cases-updates/special-populations/pregnancy-data-on-covid-19.html.



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