Brian Arola, The Free Press, Mankato, Minn.
Tue, February 7, 2023 at 7:18 AM EST
A recently released analysis of more than a dozen COVID-19 studies backed up concerns about the illness’ risk to pregnant women.
The meta-analysis in BMJ, or the British Medical Journal, reviewed data from 12 studies in 12 countries involving 13,136 pregnant women. Results showed COVID-19 infection at any time during a pregnancy “increases the risk of maternal death, several maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction.”
The analysis supports what the medical community has suspected during the pandemic, said Dr. Tara Denke, an OB-GYN at Mankato Clinic.
“COVID-19 infection was very harmful for pregnant women and their babies,” she said. “Not just cold-like symptoms, women were incredibly sick requiring ICU admission. Not only did we see that in the literature, but I saw it and so did my partners here in Mankato.”
She praised the report’s robustness. It included findings from places ranging from United States to Italy to Hong Kong to Nigeria.
Physicians look for large sample sizes from heterogenous populations when they analyze studies, said Dr. Tarek Khalife, regional chair of obstetrics and gynecology at Mayo Clinic Health System in Mankato. The larger the sample and wider the range of groups samples, the more generalized the results may be.
“The results were reassuring that we did take COVID-19 as seriously as we thought we should,” he said.
The analysis broke down relative risks of different COVID-19 complications. A value of 1.5 or higher was considered to be heightened risk.
Compared to uninfected pregnant women, pregnant women with COVID-19 had a 23 relative risk for pneumonia and a 5.5 relative risk for developing blood clots, Khalife said.
“We’re not talking about small increases in risk,” he said. “We’re talking significant risks.”
There are physiological reasons for why a pregnant woman’s body is more likely to have trouble dealing with COVID-19. The immune system is taxed when the body is working hard to grow the pregnancy, Denke said.
“The body is working overtime,” she said. ” … A pregnant woman’s body changes are quite miraculous, but there are limits.”
Other respiratory illnesses like influenza present similar risks. When alveoli, those tiny air sacs in the lungs, are filled up during an infection, the lungs sometimes compensate for it by using reserves of space.
Pregnant patients lose much of the reserve when the uterus pushes up toward the lungs, Khalife said.
“Just by the sheer amount of reduced reserve, they have a higher chance of needing intubation,” he said.
Although the risks are clear for pregnant women, a Kaiser Family Foundation survey from May 2022 found only 42% of women who were pregnant or planning to become pregnant said they were “at least somewhat confident that the vaccine is safe.” More respondents either said they were “not too confident,” 31%, or “not at all confident,” 27%.
The survey found that belief in misinformation about the vaccines and pregnancy is relatively common — not just among pregnant women, but among adults overall. Vast amounts of research show COVID-19 vaccines have been effective at limiting serious cases, hospitalizations and deaths from the illness.
Denke encouraged women to bring any concerns about vaccines to their doctors.
“Your doctor wants to keep you safe, wants to keep your baby safe,” she said. “We’re always about promoting health.”
The flood of information that people are exposed to online means they’re often seeing what they want to see and not seeing what they don’t want to see, Khalife said. Physicians are needing to find ways to keep scientific research at their forefront of their messages to patients, he added, while also understanding where patients are coming from with their concerns.