Adverse complications for COVID positive pregnant women and their newborns

Assessing 2,471 women in the third trimester of their pregnancy, close to their delivery, researchers found "significant differences" for symptomatic covid positive patients including higher rates of gestational diabetes, lower white blood cell counts and heavier bleeding during delivery, whilst respiratory complications were witnessed in their babies.

Thankfully in the group of patients -- which included 172 covid positive women (56 of whom were symptomatic) -- monitored at the Mayanei Hayeshua Medical Center in Israel, only one person needed mechanical ventilation, and there were no maternal deaths.

The peer-reviewed findings are published today in The Journal of Maternal-Fetal & Neonatal Medicine. They show, lead Dr Elior Eliasi states, that COVID-19 in the third trimester of pregnancy "has clinical implications, albeit at lower rates than expected once asymptomatic patients are taken into account."

"Our analysis finds there were no significant increase in cesarean delivery in women, who were COVID-19 positive and the incidence of preterm deliveries was not significantly different among the three groups (healthy, covid positive asymptomatic, covid positive symptomatic). Most pregnancy and delivery outcomes were similar between COVID-19-positive and -negative parturients (a woman about to give birth; in labour).

"However, There were significant differences between the COVID-19-positive and healthy controls included higher rates of GDM (gestational diabetes), low lymphocyte counts (white blood cell count) which were significantly lower, postpartum hemorrhage (bleeding during birth), and neonatal respiratory complications."

Dr Eliasi, who is based at the Mayanei Hayeshua Medical Center, adds: "Our findings support the importance of vaccinating all pregnant women at all stages of pregnancy."

The study looked at births at the hospital between 26 March and 30 September 2020. A total of 93% of women admitted to the labour ward during this period were negative for COVID-19. Of the COVID-19-positive patients, 67% were asymptomatic.

On average the increase risk of incidence of adverse outcomes was 13.8% higher for asymptomatic covid patients and 19.6% higher for those symptomatic.

"More data is now needed to better delineate the differences between pregnancy outcomes seen in certain populations, potentially related to different viral characteristics (subtypes, viral load), patient epigenetics, or other factors," the authors state.

"Additionally, the effects of maternal infection on the fetus both in terms of symptomatic maternal illness and vertical viral transmission remain to be further investigated."

Limitations of this study include it being retrospective; whilst another is that the sample includes a relatively healthy population admitted to just a single community hospital. "Therefore," the authors state their findings, "may not be generalizable to all populations."