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Pregnant women seen in hospitals with COVID-19 show fewer symptoms and appear to have an increased risk of being admitted to an intensive care unit than non-pregnant women of similar ages, according to a study published today by the BMJ.
They are also more likely to experience premature delivery and their newborns are more likely to be admitted to a neonatal unit.
Being older, being overweight, and having pre-existing medical conditions like high blood pressure and diabetes also appear to increase the risk of severe COVID-19 in these women.
Pregnant women are believed to be a high risk group for COVID-19 infection and there are concerns about the possible adverse effects of the virus on the mother and child. However, published overviews of COVID-19 in pregnancy are quickly becoming outdated as new evidence emerges.
An international team of researchers therefore began a systematic review to compare the clinical features, risk factors, and outcomes of COVID-19 in pregnant and recently pregnant women with non-pregnant women of similar ages.
Live systematic reviews are useful in fast-paced research areas like COVID-19 because they can be updated regularly as new information becomes available.
Their results are based on 77 studies that reported rates, clinical features (symptoms, laboratory and x-ray findings), risk factors, and outcomes for 11,432 pregnant and recently pregnant women who were hospitalized and suspected or confirmed to have COVID-19 .
The studies were of different design and quality, but the researchers were able to take this into account in their analysis.
Compared to non-pregnant women of childbearing age, they found that pregnant and recently pregnant women with COVID-19 were less likely to report symptoms of fever and muscle pain (myalgia), but were more likely to be admitted to an intensive care unit and need ventilation.
Maternal risk factors associated with severe COVID-19 included increasing age, high body mass index, chronic high blood pressure, and pre-existing diabetes.
Pregnant and recently pregnant women with COVID-19 were also more likely to have premature birth than women without the disease.
A quarter of all babies born to mothers with COVID-19 were admitted to a neonatal unit and were at greater risk of admission than those born to mothers without the disease. However, stillbirth and neonatal mortality rates were low.
The researchers point out some limitations to the study that may have affected their results, including differences in study size, design, and definitions of symptoms, tests, and results. However, its strengths include the large sample size and robust search methods to minimize the risk of missing studies and duplicate data.
For this reason, health professionals should be aware that pregnant women with COVID-19 may need access to intensive care and specialized baby care facilities.
In addition, mothers with pre-existing comorbidities must be viewed as a high risk group for COVID-19, along with overweight and elderly people.
Finally, they say their systematic review of life will provide a solid evidence base for life guidelines on COVID-19 and pregnancy, and will allow for quick updates as new data emerges.
BAME women make up more than half of pregnant women in UK hospitals with COVID-19
Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis, BMJ (2020). www.bmj.com/content/370/bmj.m3320
British Medical Journal
Pregnant women with COVID-19 may be more likely to need an intensive care unit and give birth early (2020, September 1).
accessed on September 2, 2020
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