Complications of pregnancy and childbirth in the context of COVID-19 have occupied the attention of scientists since the beginning of the pandemic. And if in the first months there was obviously not enough information, then over time it became clear how exactly the new coronavirus infection affects the outcome of childbirth.
So, scientists from the Institute of Systems Biology (USA) found that the new coronavirus infection SARS-CoV-2 increases the risk of adverse birth outcomes, including the risk of stillbirth. They studied the electronic health records of more than 18,000 people who were tested for SARS-CoV-2 during pregnancy. The results were published in The Lancet Digital Health and are among the first to account for the trimester of SARS-CoV-2 infection in birth outcomes.
According to the study, preterm births and stillbirths were observed mainly in women who had COVID-19 in the first or second trimester. And pregnant women who had coronavirus in the third trimester were more likely to have small babies.
Participants had mild to moderate SARS-CoV-2 infection. The scientists argue that the severity of maternal COVID-19 infection did not correlate with the baby’s gestational age at the time of birth. In addition, there were poor birth outcomes even if the mother did not experience severe respiratory problems with COVID-19 at the time of infection.
Women who tested positive for SARS-CoV-2 were more likely to have Hispanic ethnicity, race other than Asian or White, lower age, higher body mass index, lower educational attainment, and other factors scientists say also associated with negative birth outcomes.
To explain this and make a valid comparison, the researchers used a statistical matching method that controlled for confounding variables.
“Pregnant women are at increased risk of adverse outcomes after SARS-CoV-2 infection, even if the mother does not have very severe COVID-19. The health of both mother and fetus is at increased risk with COVID-19. That’s why it’s so important to protect pregnant women from infection and strengthen surveillance of sick expectant mothers,” said Jennifer Hadlock, MD, co-author of the study.
The study was conducted before COVID-19 vaccines were widely available in the US. There is an opportunity in future research to explore whether vaccination helps prevent negative birth outcomes.
Meanwhile, the Ministry of Health of the Russian Federation in December 2021 published the next version of the guidelines for organizing the provision of medical care to pregnant women, women in labor and newborns during the COVID-19 pandemic.
Separately, this document highlights the recommendation for vaccination against COVID-19 during pregnancy. Ministry of Health experts noted that at present there is no scientific data on the negative impact of the vaccine on a woman and her unborn child, and infection with a coronavirus during pregnancy, on the contrary, can cause numerous complications for both a woman and a fetus.