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Unvaccinated pregnant people are at greater risk of COVID complications, newborn deaths

FILE PHOTO: Pregnant women receive the COVID-19 vaccine in Schwenksville, Pennsylvania

According to a new study from Scotland, unvaccinated pregnant people who get COVID-19 are at much higher risk of complications from the illness and death of their babies than their vaccinated counterparts.

Authors of the study at the population level, published Thursday in Nature Medicine, examined data from all pregnant people in Scotland between December 2020 and October 2021, including information on vaccination status and infection from COVID-19. Nearly all pregnant people who needed critical care for COVID-19 — 102 out of 104 in total — were unvaccinated. There were a total of more than 450 fetal and newborn deaths that coincided with COVID-19 — all among unvaccinated mothers.

“Vaccination during pregnancy is the safest and most effective way for pregnant women to protect themselves and their babies,” said Sarah Stock, an author of the study, an obstetrician and specialist in maternal and fetal medicine at the University of Edinburgh. “This advice should go out to partners and parents and grandparents and friends.”

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The comprehensive perinatal death rate — which measures the number of babies who died from about 28 weeks gestation to about one month after birth — was just over 22 deaths per 1,000 births for pregnant people diagnosed with COVID-19 within a month of giving birth . That’s much higher than Scotland’s perinatal death rate during the pandemic of more than 5 deaths per 1,000 births.

Vaccination remains the most important distinction. When COVID-19 vaccines became available, 77% of infections among pregnant people were in those who had not been vaccinated. Pregnant people who were vaccinated during their pregnancy had a significantly lower perinatal death rate, with just over 4 deaths per 1,000 births.

During the study period, which started just before the vaccine was released to the public, more than 130,000 people were pregnant in Scotland. By October 2021, only 32% of people who gave birth that month had been vaccinated. Vaccination rates among pregnant people in the U.S. were similar at the time — 33% — although it rose to more than 41% in the new year, according to the Center for Disease Control and Prevention. In both Scotland and the US, these rates are well behind vaccination coverage in the general population.

“The best thing to avoid while pregnant is getting infected with SARS-CoV-2,” said Kjersti Aagaard, a physician and researcher in obstetrics and gynecology at Baylor College of Medicine, the virus that causes COVID-19. in Houston, Texas, who was not involved in the investigation. “The best decision you can make when you are pregnant is to get fully vaccinated.”

Although pregnancy puts COVID-19 patients at a higher risk of complications, it does not make a person more susceptible to contracting the virus, according to the researchers. Infections among pregnant people in the study were evenly distributed across trimesters, but the risk of complications increased with gestational age. Hospital admissions among pregnant people increased from less than 7% of those with COVID-19 infection in the first trimester to more than 33% of those with infections in the third trimester. No pregnant people infected with SARS-CoV-2 in their first trimester were admitted to critical care for COVID-19 complications, compared to more than 4% of those in their third trimester.

Researchers cannot necessarily distinguish between hospitalizations due to COVID-19 and those for other problems that happened to coincide with COVID-19 infection. The study also does not provide insight into how the ommicron variant may affect pregnancy. It’s part of the problem in researching COVID-19, experts said: by the time one insight is gained, the situation has already changed.

“The plane is already flying and we’re trying to figure out how to rebuild it,” said Yalda Afshar, a maternal and fetal medicine researcher and physician at the University of California, Los Angeles, who was not involved in the project. research.

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Smaller or less representative studies have previously pointed to higher risks for pregnant people infected with SARS-CoV-2. But experts praised the study from Scotland for its longitudinal design at the population level. Such an investigation is not possible in the United States, Aagaard said, because there is no central electronic medical system from which medical records can be retrieved. Even the CDCs tracked data on COVID-19 and Pregnancy comes from a network that state and local health departments must choose to participate in.

Data for the study was collected through the COVID-19 during pregnancy in Scotland study, which will continue to track anyone in the country who was or became pregnant after March 1, 2020. The researchers hope to continue analyzing the data, particularly confounding factors such as socioeconomic and demographic status.

For Aagaard, the study’s findings highlight that pregnant people are a critical population when looking at COVID-19 and other diseases. She wonders how much more coverage of the importance of vaccines could have been done if the pregnant people had been included in clinical trials? from the beginning.

“For Pete’s love, pregnant people should be included in vaccine trials,” she said. “So we don’t have to guess at the best answer and then look back at a year’s worth of data to find out if we did something wrong.”

This article is reproduced with permission from STAT. It was first published on January 13, 2021. Find the original story here.