Pregnant women with COVID-19 have increased risk of hospitalization, ICU admission, early labour: report
VANCOUVER -- A national surveillance project looking at pregnancy and COVID-19 in Canada has released preliminary findings showing expectant mothers with the disease have a slightly greater chance of hospitalization, ICU admission and early labour.
UBC obstetrics and gynaecology professor Dr. Deborah Money, who is leading the national project, told CTV News the early findings are based on information from 430 cases from B.C., Alberta and Ontario, and reflects a time period from March 1 to Sept. 30.
“For otherwise young, healthy people, these pregnant woman did have slightly higher rates of admission to hospital and admission to an intensive care unit, when we compared to both the U.S. rates of that same age group in adult women, and a sampling we looked at from B.C. and Ontario,” she said, and added there was a 2.3 per cent rate of ICU admission in the pregnant group compared to 0.4 per cent in the other group.
“It’s not a high rate of complication, so the reverse is the majority of pregnant women have a mild illness and do fine, but there seems to be slightly increased rate of these complications in pregnant women.”
Money said the higher rates of hospitalization could also be related to worry about a pregnant patient, and "perhaps a little more readily admitting them to hospital than you would a non-pregnant 25 year-old woman."
The findings also showed a slightly higher risk of early labour for COVID-19 positive pregnant women.
“What we found was a somewhat increased risk of preterm birth of 15 per cent, compared to roughly eight per cent in the population as a background, recognizing that we haven’t been able at this stage to look at the reasons for the preterm birth,” Money said.
As for the fetus, Money said it looks like the virus does not readily pass through the placenta, or cause damage.
“There does appear to be a very small rate of transmission to the baby, so that the babies actually test positive after delivery but don’t seem to be ill,” she said.
The project’s initial findings show 84 per cent of infants were not admitted to a neo-natal intensive care unit, and of the babies tested for COVID-19, less than six were positive.
“The rates of admission to a neo-natal intensive care unit were really in keeping with the prematurity rates, and primarily seem to be related to that,” Money said.
Last month, a 37-year-old woman in Abbotsford who tested positive for COVID-19 had her newborn son delivered by emergency C-section after being placed into an induced coma. The baby is healthy was able to come home with his father in late November, while his mother remains in hospital.
“That’s really the extreme worst end of the scenario, and is going to be very uncommon,” Money said. “I think that’s really wise not to over-worry pregnant women who might get this infection, that the vast majority do fine."
Money said the project aims to provide a better understanding of COVID-19 in pregnancy, and inform recommendations for pregnant women and their babies.
“At the beginning of the pandemic, when we were getting information about COVID-19 and pregnancy from China and other parts of the world, there was very little information actually, and quite contradictory information,” she said, and added this national collaboration will help to shed light on the issue in a Canadian context.
“It’s preliminary information, but it is at least in keeping with what we’re seeing from the United States and other reports out of Europe, so it does suggest that this is not entirely a benign infection in pregnancy and we should both try to avoid women getting infected and just be attentive to how they’re doing if they do develop the illness.”
Money said they will be looking at data for the end of November this week, and then will pull more every month or two, with other provinces such as Quebec and Manitoba expected to provide information in the coming days as well.
“So we will hopefully get to a full Canadian picture, but try to release information a little bit real time, just because we’re in the middle of a pandemic and we need even some information we think is valuable,” she said. “We’re all learning literally every week new information about how this virus affects us and in our case, particularly how this virus affects pregnant women and their infants.”
Midwives Association of B.C. president Lehe Spielgelman said it’s important that studies like this are being done.
“Oftentimes, maternity is left out, and for example with the COVID vaccine, we haven’t obviously been able to test that on pregnant patients,” she said. “So the more that we understand about the pregnant population the more effective we’ll be at keeping families and new babies safe.”
Spielgelman said the concern being felt by families is translating to more home visits, and requests for home births, though they are recommending COVID positive patients deliver in hospital.
“We’re certainly seeing a lot more concern and anxiety about pregnancy, birth, and post-partum, just due to living through a pandemic,” she said. “We’re spending a lot more time supporting and reassuring families.”
Spielgelman said midwives are also ensuring safety measures and protocols are in place, as well as making sure families are aware of those precautions.
“Certainly it’s important for us to continue to support pregnant patients and ensure that if they’re exhibiting any symptoms, that they’re testing on time and that we’re ensuring that when they are becoming term and ready for labour that these are also times where we’re really addressing whether there are any risks of COVID and minimizing exposures,” she said. “Midwives are certainly starting to see COVID positive patients in our practices.”
According to the most recent numbers gathered by the national project, Canada has now seen 2,143 cases of COVID-19 in pregnant women across the country. In B.C., there have been 235 cases as of Dec. 4.