Women With COVID-19 May Have More Post-Birth Complications, New Study Suggests 

A milestone study has found that women giving birth when they are infected with COVID-19, even if asymptomatic, may have more post-birth complications, including fever and hypoxia leading to hospital readmission, as compared to women who are not infected.

The study, conducted by Malavika Rabhu of Weill Cornell Medicine, observed 675 women admitted for delivery in New York. Of the women, 10.4% tested positive for SARS-CoV-2, although  78.6% of these women were asymptomatic. 

However, following birth, complications such as fever, hypoxia, readmission occurred in 12.9% of women with COVID-19 versus 4.5% of women without. 

There was also increased frequency of fetal vascular malperfusion among their newborn babies, which indicates thrombi in fetal vessels – occurring in 48.3% of women who had COVID-19 versus the 11.3% who didn’t. 

Malavika Prabhu, Weill Cornell Medicine

Cesarean rates also were higher in women infected by COVID-19, at rates of 46.7% in symptomatic COVID-19 cases, 45.5% in asymptomatic women, and 30.9% in women without COVID-19.  

These potential complications suggest impacts from COVID-19 for women and their newborn babies at the moment of delivery and beyond, Prabhu notes, speaking at a press briefing on Thursday. More research needs to be done she said, regarding the implications of COVID-19 on pregnancy. 

The risks identified are especially important for pregnant women to be aware of – if they are infected and due to give birth – particularly since some pregnant women have avoided accessing care at clinics in COVID hospitals, according to Prahbu. 

Obesity also represents a significant risk factor for enhanced disease for pregnant patients with COVID-19, added  Professor Kristina Adams Waldorf, speaking at The Union session. Waldorf who has studied the impacts of the infection on obese pregnant women in a study in Washington State.

Excess adipose tissue, which can impair immune response to viral infections, and the impact obesity has on pulmonary mechanics and breathing can make “pregnant patients that are obese prior to pregnancy more symptomatic,” Walfdorf states. 

There is evidence that suggests that there’s an increased risk for hospitalization and need for mechanical ventilation for pregnant infected patients. This is especially for pregnant patients with COVID-19, who have had their pregnancy compromised by the infection, which results in a preterm birth. Obesity would add another layer to these risks. 

“We have almost what we would consider kind of a perfect storm where there are multiple factors that are interacting at the same time that complicate the management of this pregnant patient, ultimately leading to the decision to deliver preterm.”

Image Credits: Flickr: Nuno Ibra Remane, R Santos/HP Watch.

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