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As the country faces a sixth pandemic wave, a new study shows that COVID-19 infection during pregnancy “significantly” increases the risks of hospitalization, intensive care and premature birth.
A Canadian surveillance study, the Association of SARS-CoV-2 Infection in Pregnancy with Maternal and Perinatal Outcomes, was published online Monday by the Journal of the American Medical Association.
It includes an analysis of data on 6,012 completed pregnancies between March 2020 and October 2021 in six provinces – Nova Scotia, Quebec, Ontario, Manitoba, Alberta and British Columbia.
“Unfortunately, we confirmed our suspicions that COVID for pregnant women led to more serious illness, higher hospitalization rates and higher intensive care admissions,” said senior author Dr. Deborah Money in an interview. on Monday.
“Obviously, it has affected pregnant women more than non-pregnant women when they compare their ages.
Dr. Deborah Money, a professor of obstetrics and gynecology at the University of British Columbia, is the lead author of a new national study examining COVID-19 during pregnancy. Photo: Contributed
A researcher and professor in the Department of Obstetrics and Gynecology at the University of British Columbia, Money said that at the beginning of the pandemic it was “painfully clear” that there was not much information about the effects of COVID-19 during pregnancy.
“It often happens with new diseases that pregnancy is not necessarily the first place people start,” she said.
“Not a trivial infection during pregnancy”
Money said that is why in March 2020 she launched the CANCOVID-Preg monitoring project with the support of the Public Health Agency of Canada, Canadian Institutes of Health Research and researchers from across the country.
As of October 31, 2021, there were 8,786 registered pregnancies with COVID-19 in Canada. The team analyzed the results in mothers and pregnancies of 6012 of these cases.
The data show that pregnancy is associated with a significantly increased risk of hospitalization associated with COVID-19 compared to all women aged 20-49 in the general population of Canada (7.75% vs. 2.93%). .
Pregnant people also had an increased risk of admission to intensive care / intensive care unit compared to the same non-pregnant population (2.01% vs. 0.37%).
“This basically puts pregnant women in a much older risk category, and mostly pregnant women look pretty healthy, so we don’t necessarily associate that with the risk of complications,” Money said.
Money said it was crucial for clinicians and public health planners to be aware that pregnant women are at risk for more serious COVID-19 infections and should be closely monitored. Aware of the increased risks, she said they should also be considered a priority for preventive or therapeutic drugs for COVID-19.
“This is not a trivial infection during pregnancy and we need to treat it with respect and understand pregnant women as more vulnerable to both them and their babies,” Money said. “And we really hope that this can encourage more women to get involved in vaccinations.”
Urgent vaccination during pregnancy
The study authors also found that increasing age, pre-existing high blood pressure, and those diagnosed with COVID-19 later in pregnancy were factors “significantly associated with poorer maternal outcomes.”
They also noted that non-white people were disproportionately represented in the study.
“Our study is one of the few in Canada that really shows that people who were not white had both a higher infection rate and a higher burden of complications,” Money said.
“Obviously there are some complex factors behind this, but even knowing that when it comes to targeting vaccine reports, targeting messages about raising awareness of the seriousness of COVID in this population in a culturally appropriate way is crucial.”
Money said it was important to stress that it was not just the pregnant woman who was at risk. Babies have also been found to be more vulnerable, as COVID-19 infection during pregnancy is associated with a higher risk of premature birth (before 37 weeks of gestation).
The study found that the risk was “significantly increased” in pregnancies in which the patient became infected with COVID-19. Compared to unaffected pregnancies over the same period, the risk was 11.05% versus 6.76%, “even in cases of milder illness that does not require hospitalization.”
Manny said research in Canada and worldwide continues to show that COVID-19 vaccines are safe during pregnancy and that vaccination “absolutely” reduces the risk of complications and the severity of the disease and is the most effective way to protect against the pregnant man and his baby.
She therefore called on anyone who is pregnant to be aware of the increased risk and to protect themselves and their babies by vaccinating, boosting and avoiding exposure to COVID-19 whenever possible.
“We really, really call on pregnant women to ensure that they are vaccinated as much as possible according to where they are in this series of vaccines and to know that this is not just for them, it is for them and their baby,” Money said. .
“Vaccines are safe during pregnancy and the disease is complicated during pregnancy, so we urge pregnant women to take advantage of the opportunity to be vaccinated.”
Seek help when you feel unwell
Money said their monitoring project is underway and will soon download data by March, far into the Omicron phase and higher vaccination levels in Canada.
They will also take a closer look at pregnant patients who have been hospitalized, the results in infants, and will continue to monitor COVID-19 vaccines during pregnancy “to confirm the evidence to date that the vaccine is safe.”
Anyone who was / is pregnant or breastfeeding during the pandemic is also encouraged to participate in the UBC-based national vaccine study COVERED (reported here last May). This study and register aims to document the safety of vaccines for pregnant and lactating women and you do not need to be vaccinated to participate.
Money said he also called on anyone who is pregnant to seek medical help early when they feel unwell.
“Even in this phase, where we will have a more endemic COVID, рано seek health care early and make sure you are taken before there are any serious complications,” she said.
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