Pregnant women who have symptoms of Covid-19 are more likely to undergo emergency interventions to deliver their babies, who in turn were also more likely to be admitted to neonatal ICUs, suggests a new study presented at the Anesthesiology 2021 annual meeting.

The retrospective single-center study included 101 pregnant women, aged 16 to 45 years, who had confirmed Covid-19 and were hospitalized for delivery from March to September 2020. Thirty-one out of the 101 women had symptoms, which included fever (42%), cough (39%), shortness of breath (26%), muscle pain (16%), chills (16%) and chest pain (10%).

Nearly 60% of the pregnant women who had symptoms of Covid-19 had an emergency childbirth compared to 46.5% women who were asymptomatic.

Complications such as breech position, decreased fetal movement, too little amniotic fluid (oligohydramnios), or slowing or stopping of the labor progress were more frequent in symptomatic women. Compared to the newborns of asymptomatic women, the newborns of symptomatic women had greater chances of requiring respiratory support (31.2% vs 29%) and needing intensive care (43.8% vs 36.2%). There was one case of a newborn testing positive for Covid-19 after delivery suggesting the possibility of vertical transmission.

More women underwent cesarean section in symptomatic as well as asymptomatic groups, though the rates were comparable between the two; 64.5% vs 62%, respectively. But these figures are much higher than the normal population cesarean section delivery rate in the US, which is around 32%.

This study gives an insight into how Covid-19 affects the labor process but also increases the chances of pregnancy complications. The lead author of the study, Kristine Lane, medical student said, “COVID-19 has severe systemic effects on the body, especially symptomatic patients… It is possible that these effects are amplified in pregnant mothers, who have increased fetal and maternal oxygen demands”.

The available authorised Covid-19 vaccines are recommended for pregnant women. Last week, the CDC had issued a health advisory emphasizing the urgent need to vaccinate pregnant women. In a statement, the president ACOG had said, “Whether you are pregnant, breastfeeding, trying to become pregnant, or plan to get pregnant in the future, vaccination is safe and effective, and is the best way to protect you from severe complications associated with COVID-19 infection”. India also recommends Covid-19 vaccine for pregnant women.

Source: American Society of Anesthesiologists (ASA) News Release October 9, 2021; CNN October 11, 2021