Researchers in Scotland reported on Thursday that pregnant women with Covid were not only at greater risk of developing serious illness, but also more likely to lose their fetuses and babies in the womb or shortly after birth, per compared to other women who gave birth during the pandemic.
The risk of losing a baby through stillbirth or the first month of life was highest among women who gave birth within four weeks of the onset of a Covid infection: 22.6 deaths per 1,000 births, four times the rate in Scotland 5.6 deaths per 1,000 births.
All of these deaths occurred during pregnancies in unvaccinated women, the researchers found. “Somewhat strikingly, no infant deaths occurred among women who had SARS-CoV-2 and who were vaccinated,” said Dr. Sarah J. Stock, first author of the paper, an expert in maternal-fetal medicine at the Usher Institute of the University of Edinburgh in Exeter. .
The study also found a higher rate of premature births in women diagnosed with Covid, a rate that increased if the baby was born within a month of the mother’s illness. More than 16% of these women gave birth before 37 weeks of pregnancy, compared to 8% among other women.
In Scotland, as in the United States, vaccination rates for pregnant women are low. Only a third of pregnant women are vaccinated against the coronavirus, despite the protections offered by vaccination. Early research found no evidence that the Pfizer-BioNTech or Moderna vaccines pose serious risks during pregnancy.
Indeed, the Scottish study found that the vast majority of infections in pregnant women were in those who were not vaccinated at all or were only partially vaccinated. Only 11% of the total number of infections were reported in fully vaccinated pregnant women.
Unvaccinated pregnant women were also four times more likely to be hospitalized than vaccinated pregnant women.
Dr Stock and colleagues analyzed data collected by the Covid-19 in Pregnancy in Scotland study, a national cohort of all women who were pregnant or became pregnant after March 1, 2020, through to the end of October 2021 The team followed 144,546 pregnancies among 130,875 women during this period.
A weakness of the study is that the authors did not adjust for confounders, like maternal age or pre-existing medical conditions, that could lead to poor pregnancy outcomes regardless of coronavirus infection or diagnosis. of Covid (they also did not know if the women who were hospitalized were admitted due to Covid disease, or were simply found to be positive on admission).
Vaccination rates are low among pregnant women across the board, but are particularly low among younger women and those from lower socioeconomic backgrounds, the study notes. Future analyzes will take these demographic and other confounding factors into account, the authors said.
Yet the differences in rates of hospitalization, preterm birth and infant loss between vaccinated and unvaccinated women are so stark that these adjustments are unlikely to change the conclusions, Dr. Stock and colleagues said.
They urged pregnant women to get vaccinated, echoing calls from health officials in the United States.
“The key takeaway that we would like to convey is that the best way to protect mother and baby is to vaccinate as early as possible, and this can be done at any stage of pregnancy,” Aziz Sheikh said. , population health researcher. at the University of Edinburgh and another of the authors of the article.
“We have enough information to get the very strong message around promoting vaccination in pregnancy now,” said Rachael Wood, consultant in public health medicine at Public Health Scotland and a member of the team at the ‘study.