Pregnant women at higher risk of death

PREGNANT women hospitalised for Covid-19 face higher risk of death than infected women admitted for other illnesses.

So found a new study published in the International Journal of Gynecology & Obstetrics, which also found that maternal tuberculosis, but not HIV co-infection or other comorbidities, was associated with admission for Covid-19.

The study's co-principal investigator and head of the Global Surgery Division at UCT, Associate Professor Salome Maswime, said the present national observational study assessing the symptoms and associations between Covid-19 in pregnancy and maternal and neonatal outcomes shows that about 7.5% of all admitted women required invasive ventilation, three-quarters of whom were admitted specifically for the management of Covid-19.

The researchers analysed data on pregnant women with Covid-19, hospitalised between April 14 and November 24 last year.

A total of 36 hospitals submitted data on 673 infected pregnant women, with 217 (32.2%) admitted for Covid19 and 456 for other illnesses.

There were 39 deaths with a case fatality rate of 6.3%, 32 (14.7%) deaths occurred in women admitted for Covid-19 compared with seven (1.8%) in women admitted for other illnesses. Of the women, 106 (15.9%) required critical care.

“Women with respiratory symptoms and admitted primarily for clinical Covid-19 were more likely to require invasive ventilation, need critical care, and were at higher risk of death,” said Maswime.

She said more than half (61%) of the women admitted for clinical Covid-19 were obese (using BMI) and just over a third (33%) were 35 and older. The rates of Caesarean delivery were high but did not differ significantly between women admitted for Covid-19 and those for other illnesses.

There were 179 (35.4%) pre-term births, 25 (4.7%) stillbirths, 12 (2.3%) neonatal deaths and 162 (30.8%) neonatal admissions.

Neonatal outcomes did not differ significantly from those of infected women admitted for other illnesses.

Dr Samantha Budhram, head of the Materno-Foetal Medicine unit at the University of KwaZulu-Natal (UKZN) and one of the principal investigators said: “The overall prevalence of HIV infection in our study was 33.4% compared to a national average of 30.7% among antenatal clinic attendees. No significant difference in prevalence of HIV infection was observed between women admitted for clinical Covid19 and those with Covid-19 infection admitted for other reasons.”

Dr Laura Yates, consultant clinical geneticist and honorary senior lecturer at UKZN, said: “The vaccine has been found to be safe in pregnancy and we encourage all women to be vaccinated to reduce the risk of getting severe disease. Pregnant women should be vaccinated any time throughout pregnancy as per new recommendations from the national Department of Health.”