Pregnant women with Covid-19 are less likely to have symptoms, but more likely to need intensive care, and give birth early, a study has shown.
Being older, overweight, and having other medical conditions, such as diabetes and hypertension, also increase their risk of experiencing more serious disease.
The research, published in the BMJ, found that pregnant women seen in hospitals with Covid-19 appear to be at increased risk of needing admission to an intensive care unit than non-pregnant women of similar age. They are also more likely to give birth pre-term birth, while their newborns are more likely to be admitted to a neonatal unit.
These findings are based on 77 studies reporting rates; clinical features (symptoms, laboratory and X-ray findings); risk factors; and outcomes for 11,432 pregnant and recently pregnant women admitted to hospital and diagnosed as having suspected or confirmed Covid-19.
The studies, which were peer-reviewed and included meta-analyses, were designed differently and were of varying quality, but the researchers allowed for this within their analysis.
Compared with non-pregnant women of reproductive age, they found that pregnant and recently pregnant women with Covid-19 were less likely to report symptoms of fever and muscle pain (myalgia), but were also more likely to require ventilation.
Additionally, a quarter of all babies born to mothers who had Covid-19 were admitted to a neonatal unit and were at increased risk of admission than those whose mothers did not have the virus. Despite this, stillbirth and newborn death rates were low.
It was noted that some limitations may affect the results, including differences in study size and design, and definitions of symptoms, tests, and outcomes. However, the large sample size and types of research methods should minimise the risks these may pose.
In conclusion, the researchers feel that healthcare professionals such as GPs should be aware that pregnant women with Covid-19 might need access to intensive care and specialist baby care facilities.
Pregnant women were advised by the chief medical officer in March to take extra care against potentially contracting Covid-19. This was considered a precautionary approach due to a lack of evidence, but the study noted that new developments are emerging in this area. Living systematic reviews, which in this case compare clinical features, risk factors, and outcomes, can be updated regularly as new information becomes available.