COVID-19 death rates higher in pregnant women than in individuals of the same age

Contraction of COVID-19 during pregnancy can have fatal consequences for the mother, a new study published today in American Journal of Obstetrics and Gynecology watch.

The study, which followed 240 pregnant women between March and June 2020, found that the COVID-19 death rate in pregnant women was significantly higher compared to the COVID-19 death rate in individuals of similar age. in Washington State.

Specifically, the study found:

• Pregnant women with COVID-19 had a 3.5 times higher COVID-19 associated hospitalization rate than the general population of similar age in Washington state.
• COVID-19 death rates were 13 times higher in pregnant women than in individuals of the same age. That being said, most pregnant patients with COVID-19 had asymptomatic or mild COVID-19 illness and healthy pregnancies.
• The three women who died from COVID-19 in Washington state were from ethnic minority groups and most of them had other conditions such as obesity and high blood pressure.

Of the 240 pregnant women with SARS-CoV-2 infections detected through June, three have died from COVID-19, while 24 patients have been hospitalized for COVID-19. Dr Kristina Adams Waldorf, an obstetrician-gynecologist at the University of Washington School of Medicine and lead author of the study, noted that this shows severe underreporting of COVID-related mortality among mothers in the United States. United.

“The death rate was incredibly high,” Adams Waldorf said. “We were very surprised by this.”

The three maternal deaths in the study cohort in Washington state represent 6.7% of all maternal deaths associated with COVID-19 counted across the United States through mid-October, although that annual births in collaborating sites represent only 1.4% of annual births nationally. , she says.

“We are gravely concerned that maternal deaths associated with COVID-19 have been massively underestimated nationally and that the impact on pregnant patients, especially with underlying conditions, is greater than what is currently underestimated, ”she added. The date was compiled by a Washington state collaboration that included 35 large hospitals and clinical systems. They made 61 percent of the state’s 86,000 annual deliveries. The Washington State COVID-19 in Pregnancy Collaborative was led by Dr. Adams Waldorf and Dr. Erica Lokken, an epidemiologist at the University of Washington.

The study made several comparisons between the clinical course of COVID-19 and the 2009 H1N1 influenza virus.

Unlike the 2009 H1N1 influenza virus pandemic, when pregnant women were quickly identified in the United States as a high risk and vulnerable group, pregnancy was not identified as a high risk condition for disease. COVID-19 or death for the first, critical eight months of the pandemic, the report notes.

Overall, the data from this study indicates that pregnant patients are at risk for serious or critical illness or death compared to non-pregnant adults, as well as for premature births, the report concludes.

“The idea that pregnant patients were protected from COVID-19 is a myth,” said Adams Waldorf.

Using this data in the report is important, Waldorf notes, because it can guide public health workers and physicians in their COVID-19 mitigation among vulnerable populations. Pregnant health workers are already receiving the COVID-19 vaccine. But since January 27, most pregnant women have not been included in the groups that can now be vaccinated.

“Our data indicates that pregnant women have not avoided the pandemic as we hoped and that communities of color bear the greatest burden,” Waldorf said. She urges pregnant women to discuss the risks and benefits of COVID-19 vaccination with their antenatal care provider.

These results suggest that excluding pregnant patients from COVID-19 vaccine trials was a mistake. Here is a large group who are generally very vulnerable to influenza infections and yet they have been excluded from COVID-19 vaccine trials. Pregnant patients should have been given the opportunity to enroll in vaccine trials so that we could better understand the risks and benefits of the vaccine for them. “

Dr. Kristina Adams Waldorf, Obstetrician-Gynecologist, University of Washington School of Medicine

Adams Waldorf added that while the community may be dealing with fatigue from COVID-19, now is not the time to let our collective guard down, especially with the new variants present in our communities.

“We should always be very careful about the size of our bubble within our families, be very careful about handwashing and using masks, and doing whatever we can until we are finished. ‘enough of the population is vaccinated for us to have herd immunity in the United States. , ” she says.