COVID-19 linked to complications during pregnancy, study finds

Date:
January 13, 2022
Source:
University of Edinburgh
Summary:
Women who have COVID-19 towards the end of their pregnancy are
vulnerable to birth-related complications. They are more likely
to have complications than those who get COVID-19 in the earlier
stages of pregnancy or who haven't had COVID-19 at all, according
to a new study.



FULL STORY ========================================================================== Women who have Covid-19 towards the end of their pregnancy are vulnerable
to birth-related complications.


==========================================================================
They are more likely to have complications than those who get Covid-19
in the earlier stages of pregnancy or who haven't had Covid-19 at all.

The findings show that preterm births, stillbirths and newborn deaths
are more common among women who have the virus 28 days, or less, before
their delivery date.

The majority of complications, which also include Covid-related critical
care admissions, occurred in unvaccinated women, according to one of
the first national studies of pregnancy and Covid-19.

Researchers say more should be done to increase vaccine uptake in
pregnant women, whose vaccination rates are much lower than those of
women in the general population.

The team analysed data relating to all pregnant women in Scotland. It
included more than 87,000 women who were pregnant between the start of vaccination uptake in December 2020 and October 2021.



========================================================================== Vaccination uptake during the study period was lower in pregnant women, compared with women aged 18 to 44 in the general population.

Some 32 per cent of pregnant women who gave birth in October 2021
were fully vaccinated -- meaning more than 14 days had elapsed since a
second vaccine, this was compared with 77 per cent of the general female population aged 18 to 44.

Since the start of Scotland's vaccination programme, a total of 4,950
cases of Covid-19 have been confirmed during pregnancy, with 77 per cent
of these cases in unvaccinated women.

Some 12 per cent of Covid-19 cases were in partially vaccinated pregnant
women -- those who had only received one vaccine dose, or were diagnosed
less than 14 days since their second dose. This compares with 11 per
cent of cases in fully vaccinated women.

The team analysed data on extended perinatal deaths, which is defined
as death of a baby in the womb after 24 weeks of pregnancy, or in the
first 28 days after birth.



==========================================================================
They found that the extended perinatal death rate among babies born within
28 days of their mother developing Covid-19 was 23 per 1,000 births.

All baby deaths occurred to women who were unvaccinated against Covid-19
at the time of infection.

Some 17 per cent of babies born within 28 days of their mother developing Covid-19 were delivered prematurely -- more than three weeks before
their due date.

These data were then compared to the background rates of extended
perinatal deaths and preterm births, which are the rates for all babies
born in Scotland regardless of whether their mother had previously had
Covid-19 or been vaccinated.

The background perinatal mortality rate during the pandemic in Scotland
was six per 1,000 and preterm birth rate was 8 per cent.

Experts stressed that it is not possible to say if Covid-19 contributed directly to the deaths or preterm births as they did not have access to detailed clinical records for individual women.

Admission to hospital and critical care were also significantly more
common in pregnant women with Covid-19 who were unvaccinated at the
time of diagnosis than in vaccinated pregnant women -- 98 per cent of
women with Covid-19 during pregnancy who were admitted to critical care
were unvaccinated.

The team also monitored complication rates in women who received a
Covid-19 vaccination during pregnancy.

The perinatal mortality and preterm birth rates in women within 28 days
of receiving a vaccine were very similar to the background rates at four
per 1,000 and eight per cent, respectively, providing further reassurance
on the safety of vaccination during pregnancy.

These findings are part of the COPS study, which provides population-based information for the whole of Scotland on the incidence and outcomes of
Covid-19 infection and Covid-19 vaccination in pregnancy.

COPS is an offshoot of the EAVE II project, which uses anonymised linked patient data in Scotland to track the pandemic and the vaccine roll out
in real time.

The research team included scientists from the Universities of Edinburgh, Glasgow, Aberdeen, Strathclyde, and St Andrew's; Public Health Scotland;
and Victoria University of Wellington.

COPS co-lead Dr Sarah Stock, of the University of Edinburgh's Usher
Institute - - who is also a consultant obstetrician -- said: "Our data
add to the evidence that vaccination in pregnancy does not increase the
risk of complications in pregnancy, but Covid-19 does.

"Covid-19 vaccination in pregnancy is crucial to protect women and
babies from preventable, life-threatening complications of Covid-19."
The findings have been published in Nature Medicine. This work was funded
by Wellcome and the charity Tommy's and supported by the charity Sands.

EAVE II study lead Professor Aziz Sheikh, Director of the Usher Institute, said: "Our national data show that being vaccinated during pregnancy was associated with reduced risk of serious outcomes for both mother and baby.

"Vaccine uptake has been much lower in pregnant women than in non-pregnant women of a similar age in Scotland. As cases of Omicron continue to
rise, I strongly encourage all pregnant woman to take up the offer of
a vaccination or booster as these will help protect them and their
unborn child." COPS co-lead Dr Rachael Wood, Consultant in Public
Health Medicine with Public Health Scotland, said: "Our data provide
valuable information on both Covid-19 infections and vaccinations among pregnant women.

"It is clear that vaccination is the safest and most effective way
for pregnant women to protect themselves and their babies from severe
Covid-19 disease.

"Vaccination can be given at any stage of pregnancy, so
I strongly encourage women who are pregnant, or hoping to
become pregnant, to get fully vaccinated as soon as possible." ========================================================================== Story Source: Materials provided by University_of_Edinburgh. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Sarah J. Stock, Jade Carruthers, Clara Calvert, Cheryl Denny, Jack
Donaghy, Anna Goulding, Lisa E. M. Hopcroft, Leanne Hopkins, Terry
McLaughlin, Jiafeng Pan, Ting Shi, Bob Taylor, Utkarsh Agrawal,
Bonnie Auyeung, Srinivasa Vittal Katikireddi, Colin McCowan, Josie
Murray, Colin R. Simpson, Chris Robertson, Eleftheria Vasileiou,
Aziz Sheikh, Rachael Wood. SARS-CoV-2 infection and COVID-19
vaccination rates in pregnant women in Scotland. Nature Medicine,
2022; DOI: 10.1038/s41591-021-01666-2 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220113111358.htm
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