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A government analysis has found that pregnant women with COVID-19 are more likely to be hospitalized, admitted to the ICU, and put on ventilators than infected non-pregnant women.
The report also found that Black and Hispanic pregnant women were more susceptible to the virus than white pregnant women.
It’s unclear how many hospitalized women were admitted for labor and delivery versus coronavirus complications.
Much remains unknown about how the coronavirus affects pregnant women and their future children, but the report underscores the importance of taking serious precautions and addressing racial disparities.
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Pregnant women with COVID-19, the disease the coronavirus causes, are more likely to be hospitalized, admitted to the intensive care unit, and put on ventilators than non-pregnant women with the disease, according to a new CDC analysis including over 90,000 US women.
The report, the largest of its type to date, also found that Black and Hispanic pregnant women may be disproportionately affected by COVID-19.
While the analysis comes with many caveats — namely, that it’s unclear how many of the women were hospitalized due to labor and delivery, or pregnancy complications unrelated to COVID-19 — it provides important data on a group that scientists have known little about.
It also underscores recommendations for pregnant women and their providers to take COVID-19 infections seriously, and for the healthcare system to address disturbing racial disparities.
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The report found almost a third of COVID-positive pregnant women were hospitalized
For the study, researchers compared 8,207 COVID-positive pregnant teens and women to 83,205 of their infected peers who were not pregnant.
They found that more than 31% of the pregnant women were hospitalized, 1.5% were admitted to the ICU, and 0.5% needed to be put on ventilators. Of the non-pregnant women, 6% were hospitalized, 0.9% went to the ICU, and 0.3% were ventilated.
Pregnant women with COVID-19 were not any more likely to die.
The findings are reminiscent of a recent study out of Sweden showing that COVID-positive pregnant women were five times more likely to be admitted to the ICU and four times more like to be ventilated than non-pregnant women.
While the American College of Obstetricians and Gynecologists (ACOG) has considered pregnant women an at-risk population for COVID-19 since they’re susceptible to greater morbidity and mortality from other respiratory conditions like the flu, the CDC has maintained that the virus doesn’t seem to “affect pregnant people differently than others.”
This new data calls that conclusion into question.
“I think the bottom line is this: These findings suggest that compared to nonpregnant women, pregnant women are more likely to have severe COVID,” Dr. Denise Jamieson, head of the COVID-19 task force at ACOG, told the New York Times.
While not addressed in the current study, it still seems that women can’t pass the virus to their babies in utero or through breastmilk, and that most newborns who do test positive for COVID-19 have mild or no symptoms, and completely recover.
Pregnant women of color seemed to be especially susceptible to COVID-19
Among the pregnant women with COVID-19 who reported race/ethnicity, 46% were Hispanic, 22% were Black, and 23% were white.
Set against data from women who gave birth last year — 24% Hispanic, 15% Black, and 51% were white — the findings suggest women of color are disproportionately susceptible to COVID-19 during pregnancy.
Earlier research out of the UK found more than half of pregnant women who were admitted to the hospital with COVID-19 were Black or from other minority ethnic groups.
Other reports have shown that people of color, pregnant or not, are more susceptible to severe COVID-19 infections and deaths due to systemic racism, and ACOG has long known that serious disparities in women’s health care persist, with Black Americans three to four more times likely to die from childbirth or pregnancy complications than women.
Marian Knight, the lead author of UK study, previously told Insider more qualitative research involving talking to women about their experiences is “urgently needed” to help understand what puts pregnant women of color at such risk for COVID-19, be it household arrangements or jobs that make physical distancing difficult, restricted access to healthcare, something else, or all of the above.
The answers will likely differ between minority groups, making the questions even trickier to answer, Knight, a professor in the University of Oxford’s Nuffield Department of Population Health, said. “We have to accept that it’s difficult, but that doesn’t mean we shouldn’t be trying to tackle it.”
The report comes with important caveats but pregnant women should still take the coronavirus seriously
The current report has important limitations, most glaringly that it’s unclear why the hospitalized women were admitted — for labor, delivery, or another pregnancy-related issue, or because their COVID was severe?
Plus, clinicians are more liberal when it comes to admitting and providing care for pregnant women in general, so it would make sense that they’d experience higher rates of hospitalization than non-pregnant women.
A lot of data was missing, too, forcing the researchers to make assumptions, for example that if a certain negative outcome wasn’t reported, it didn’t occur.
The analysis also couldn’t answer whether having COVID-19 is linked with adverse pregnancy outcomes, like pregnancy loss or preterm birth, although the CDC has maintained that it is, since that’s the case with other respiratory illnesses.
What the report does do, however, is provide needed data about a population researchers and doctors are still learning a lot about, and emphasize that women and their providers need to take the risk COVID-19 infection seriously.
“The emerging data on the increased risk of more severe illness among people who are pregnant is something that has become more visible as we have increasing numbers of cases occurring,” Dr. Jay Butler, CDC Deputy Director of Infectious Diseases and COVID-19 Response Incident Manager, said during a press briefing Thursday.
“I would anticipate that we’ll get more granularity on our understanding of the degree of risk as we continue on and we have additional data,” he continued.
Meantime, the study authors advise pregnant women to continue with their regular prenatal care appointments, limit interactions with others and take precautions like mask-wearing and social distancing when they do occur, and keep at least a 30-day supply of medicines.
Because another recent study has shown pregnant women, whether or not they have COVID-19, are also at high risk for depressive and anxiety symptoms during the pandemic, it’s also critically important for them to seek support, whether from friends and family, online support groups, a mental health provider, or all of the above.
“There are going to be a lot of emotions, some of which are sadness, grief and the unknown,” Dr. Jane van Dis, an OB-GYN who serves as medical director at the telemedicine network Maven, previously told Insider. “Just know that connecting with people who are there to support women is essential for mental health.”
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