Pregnant women are at a higher risk of suffering severe Covid-19, particularly if they are from ethnic minority backgrounds or have pre-existing conditions, global research has found.
The research, led by the University of Birmingham and World Health Organization, found pregnant women are more likely to be admitted to intensive care and need invasive ventilation after contracting coronavirus than non-pregnant women of reproductive age.
Scientists looked at 64,676 pregnant and recently pregnant women (in the postpartum or post-abortion period), and 569,981 non-pregnant women, with Covid-19 across 192 international studies as part of an ongoing review. The research began in April 2020 and follows their first publication last August.
The study also revealed that one in 10 pregnant and recently pregnant women in hospital for any reason had Covid-19. A total of 339 pregnant women (out of 41,664 from 59 studies) died after diagnosis.
Lead author Dr John Allotey, of the University of Birmingham, argued that ‘pregnant women should be considered a high-risk group’ but should ‘also be reassured that the risk to their babies is very low’.
He singled out expectant women with increased maternal age, high body mass index, non-white ethnicity and pre-existing conditions, such as chronic hypertension and diabetes, as particularly at risk of developing severe Covid-19.
The most common Covid-19 symptoms in pregnant women were fever (40%) and cough (41%). However, pregnant women were more likely to be asymptomatic than non-pregnant women.
The overall rates of stillbirth and neonatal death are low in women with suspected or confirmed Covid-19, the review found.
It also included evidence that pregnancy specific conditions, such as pre-eclampsia and gestational diabetes, may be associated with severe Covid-19, but the authors stated that more data was needed.
Professor Shakila Thangaratinam, also a study author from the University of Birmingham, said: ‘Pregnant women and healthcare professionals will need to take into account the additional risks faced by pregnant women with Covid-19 in making decisions such as taking-up of vaccines if offered to prevent Covid-19, and plan management in pregnancy.’
Currently, the Joint Committee on Vaccination and Immunisation (JCVI) does not recommend pregnant women get the vaccine –unless their risk of exposure to the virus is high and cannot be avoided, or if underlying conditions place her at a very high risk of complications.
Although there is no evidence of safety concerns or harm to pregnancy, there is ‘insufficient data to recommend routine use of Covid-19 vaccines during pregnancy,’ it said.
The large clinical trials, which showed that Covid-19 vaccines are safe and effective, did not include pregnant women.