A new study that examines how SARS-CoV-2 affects pregnant women around the world ends with a message that’s all too familiar, but public health officials say is too often ignored: Get vaccinated.
Pregnant women infected with the virus that causes COVID-19 are seven times more likely to die and three times more likely to be rushed to emergency departments compared to uninfected pregnant women, according to a study in BMJ Global Health.
Despite the findings in this and other studies that underscore the many complications that COVID-19 can present to pregnant women, more than 80 countries around the world do not recommend that pregnant and lactating women get the vaccine, according to Emily R. Smith, an assistant professor of global health at George Washington University Milken Institute School of Public Health and lead author of the study.
Even some doctors won’t encourage pregnant women to get the COVID-19 vaccine although it is recommended, Smith added in a university press release.
She and co-authors hope that their sequential, prospective meta-analysis that examines data from 12 studies conducted in 12 countries, including the U.S., will persuade public health officials, physicians and patients of the critical role COVID-19 vaccination plays in enabling positive pregnancy outcomes.
The study compares data from 1,942 women who’d tested positive for SARS-CoV-2 infection to 11,194 pregnant women who’d tested negative. Researchers began planning the meta-analysis in April 2020 and found candidates through key stakeholders and professional research networks that had agreed to participate by Aug. 1, 2020.
“We also identified studies by reviewing the most recently published PregCOV-19 Living Systematic Review to identify studies that might be eligible for post-publication inclusion into the analysis; we contacted all corresponding authors of apparently eligible studies,” the study said.
In a teleconference included in the university’s press release, Smith said that “one of the strengths of this particular study is that we had data from all over the world. And we also had pregnant women that were in the first trimester, the second trimester, the third trimester. That’s something new here too. That COVID at any time in pregnancy did bring that extra risk on.”
In addition to the mortality risk, unvaccinated pregnant women who get infected are:
- At about 15 times higher risk of needing to be put on a ventilator.
- At about 23 times higher risk of developing pneumonia.
- At more than 5 times higher risk of developing blood clots.
Mothers who are unvaccinated also put their babies at risk. Babies born to women who aren’t vaccinated are:
- Almost 2 times as likely to be admitted to a neonatal intensive care unit.
- Almost 2 times as likely to be born prematurely.
- Almost 3 times as likely to be born moderately preterm, and preterm babies are at higher risk of having lifelong health problems including delays in early childhood cognitive development.
- 1.19 times as likely to be born with low birth weight.
The study did not find any link between SARS-CoV-2 infection and being born small for gestational age nor for stillbirth at or beyond 28 weeks’ gestation. However, the study added that “globally, key health outcomes such as stillbirth have various definitions, and the published literature does not report on a comprehensive set of maternal and newborn outcomes.”
Ten of the studies collected data on maternal deaths, but only three recorded deaths during the study period, so those were the data used in that category, according to the study. “Based on these three studies, women with SARS-CoV-2 infection had an increased risk of maternal death … as compared with uninfected pregnant women.”
Smith said in the teleconference that “we had pregnant women that were in the first trimester, the second trimester, the third trimester. That’s something new here too. That COVID at any time in pregnancy did bring that extra risk on.”
The study concluded that there needs to be “global efforts to prevent COVID-19 during pregnancy through targeted administration of vaccines and non-pharmaceutical interventions. Further efforts are needed to advance our understanding of the best clinical care and management strategies for SARS-CoV-2-infected pregnant women and their newborns.”