Covid-19: Riskier than expected for Pregnant Women?
The COVID-19 pandemic has pushed many health systems to the brink, resulting in non-urgent care being deprioritized to make way for thousands of COVID-19 patients. However, there are some areas that cannot wait, and one of them is maternal health.
Reductions in access to and use of essential maternal and new-born health services during epidemics translate into increases in the number of women and newborns who suffer complications during pregnancy, childbirth, and the postnatal period. Examples from Italy, Germany, the United Arab Emirates (UAE), and Israel show that a swift recalibration of health care has helped to maintain the provision of essential services in a safe manner, and therefore the well-being of pregnant women and their babies, during the pandemic.
The assessments of the dangers of Covid-19 in pregnancy were reassuring in the first months of the pandemic. There is now data from more than 11,000 pregnancies worldwide, which changes the picture somewhat. Accordingly, a Sars-CoV-2 infection for mother and child could harbour slightly higher risks than previously thought. Although they are still low in the overall comparison for the individual pregnant woman – but apparently higher for non-infected expectant mothers.
There is no reason to be overly concerned – but prioritise to take precautions to protect yourself particularly well from infection as a pregnant woman.
Often difficult courses
Naturally, pregnant women tend to be younger women. This means that their basic risk for severe Covid-19 courses is significantly lower than for older patients. Compared to infected, non-pregnant women of childbearing age, according to the French survey study, they had to be treated in intensive care with a 62% higher probability. The probability of having to be ventilated was even increased by 88%. However, the risk of death for the mothers remained low.
Less fever, less muscle pain
At first, it seemed paradoxical that pregnant infected people suffered fewer symptoms such as fever and muscle pain overall than non-pregnant women.
One possible explanation: The immune system of pregnant women is down-regulated by nature so that it does not attack the child – which is in a way a stranger in its own body. On one hand, this explains the absence, but on the other hand, it also explains the weakness of some symptoms – because these are usually reactions of the immune system to the pathogen.
However, this also reduces resistance to the virus. These circumstances also explain why pregnant women do not get the flu more often, but more severely. It is therefore recommended that pregnant women get a flu shot.
Additional risk factors, worse prognosis
The risk of a severe course of Covid-19 was particularly increased if the pregnant women brought additional risk factors with them. These included:
- a higher age of the mother
- a high body mass index
- high blood pressure
- pre-existing diabetes
These factors generally have an unfavourable effect on the course of a Coronavirus infection.
Premature births and miscarriages
A Sars-CoV-2 infection in the mother could also have negative effects on unborn babies. According to the study, children of infected women are three times more likely to be born prematurely than children of uninfected mothers. To what extent the Coronavirus infection was actually decisive here and no other factors are open.
One reason for this could be that Sars-CoV-2 can also affect the placenta. Blood clots are also more common, this can worsen the baby’s care.
But other reasons are also possible. For example, it could have been purely safety precautions or some children could have been deliberately fetched earlier in order to better care for the seriously ill mother. But other risk factors for the mother such as being overweight, which provoke severe diseases even in non-pregnant women, could have been the trigger.
Overall, the number of miscarriages and newborns who died was low, even among mothers suffering from Covid-19.
Unborn babies are also infected – but very rarely
The probability that the child will be infected in the womb is very low according to more recent findings. Still, it is possible. Corresponding cases of so-called vertical transmission have since been documented again and again.
The results of the investigations are based on 77 studies with a total of 11,432 pregnant women. The design of the studies was different and of varying quality, but this was taken into account in the analysis, say the researchers.
Conclusion
Being pregnant in the time of Coronavirus will certainly disrupt some of your plans, and the overall maternity care experience. However, there are resources available to help you make pregnancy and maternity as stress-free as possible. For example, by securing maternity health insurance from HanseMerkur, not only do you get the best benefits for the price you pay, including access to a superior Employee Assistance Program (EAP), but also a dedicated team to help you with claims and procedures throughout your journey.
As an award-winning insurer with over 140 years of experience, HanseMerkur specializes in International Medical Insurance, including Individual and Family Health Insurance Plans. We also provide specialized Newborn Insurance Plans that can offset costs in case your newborn needs extra care.