Pregnant women who contract SARS-CoV-2 within 28 days of their delivery date are at increased risk of perinatal and maternal complications

Pregnant woman and GP

According to a new Scottish study, pregnant women who contract severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) within 28 days of their delivery date have an increased risk of perinatal and maternal complications. Furthermore, the majority of the complications, including COVID-19-related critical care admissions, are likely to occur in pregnant women who are not vaccinated against COVID-19.

The findings, published in Nature Medicine, come from the COVID-19 in Pregnancy in Scotland (COPS) study, a substudy of the larger EAVE II project. Researchers at the Universities of Edinburgh, Glasgow, Aberdeen, Strathclyde, and St Andrew’s, Public Health Scotland, and Victoria University of Wellington assessed COVID-19 vaccine uptake and outcomes of SARS-CoV-2 infection in pregnant women using data from the national cohort.

Vaccination uptake 

A total of 25,917 COVID-19 vaccine doses were administered to 18,457 pregnant women between 8 December 2020 and 31 October 2021 in Scotland. Pregnant women aged 18–44 years had lower vaccination uptake rates than women in the general population (32.3% versus 77.4%, respectively, are fully vaccinated). Uptake was lowest among younger women and those residing in the most deprived areas.

Among the 4950 COVID-19 cases reported during pregnancy since the start of the vaccination program, unvaccinated women accounted for 77.4% (95% confidence interval [CI] 76.2–78.6) of the cases.

Perinatal and maternal outcomes 

The extended perinatal mortality rate for women delivering within 28 days of a COVID-19 diagnosis was 22.6 (95% CI 12.9–38.5) per 1000 births compared with a background rate of 5.6 (95% CI 5.1–6.2) per 1000 births during the pandemic. All perinatal deaths during the study period were reported in unvaccinated women.

The preterm birth rate for women delivering within 28 days of a COVID-19 diagnosis was 16.6% (95% CI 13.7–19.8) compared with a background preterm birth rate of  8.0% (95% CI 7.8–8.1) during the pandemic.

Unvaccinated women accounted for 90.9% (95% CI 88.7–92.7) of COVID-19-related hospitalisations and 98.1% (95% CI 92.5–99.7) of COVID-19-related critical care admissions during pregnancy.

Importance of vaccination 

Commenting on the findings, the study’s corresponding author, Dr Sarah Stock from the University of Edinburgh, 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.’

Echoing Dr Stock’s comments, Professor Nicola Steedman, Deputy Chief Medical Officer for Scotland, said: ‘These findings are of concern and reinforce the importance for pregnant women or those thinking of getting pregnant of getting vaccinated as soon as possible.’

This article originally appeared on Medscape, part of the Medscape Professional Network.


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