Severe COVID-19 in pregnant women could lead to early deliveries, pregnancy loss and even maternal death according to a study conducted in Maharashtra using the data of over 4,000 pregnant women across the state.
The study published in collaboration with the Indian Council of Medical Research's- National Institute for Research in Reproductive Health used data from the PregCovid registry which included both pregnant as well as post-partum women who had delivered recently.
From over 4,203 women that were infected with COVID-19 between March 2020 and January 2021, 34 women died. Ten of these women had already delivered their child while the remaining were pregnant. Over 3865 women were infected and registered on the portal when they were pregnant while 338 were infected and registered post-partum (within six weeks of child birth). These women were admitted to 19 hospitals across Maharashtra that are part of the cohort study on PregCovid.
Over 3669 women were asymptomatic and the remaining 534 were symptomatic. From the ones who are symptomatic, 382 were classified to have mild COVID-19, 112 were classified as moderate, and 40 were classified as having severe COVID-19. The researchers concluded that vaccination in pregnant women would assist in reducing the COVID-19 burden among this group.
The Centre approved COVID-19 vaccines for pregnant women from July 2, 2021 across India.
Close to 158 women from the total number needed to be shifted to the Intensive Care Unit/ High-Dependency Units and over 152 of them had to receive extra care due to the COVID-19 complications. While the women received treatment according to the guidelines of the National clinical management protocol for COVID-19, many of them needed oxygen therapy, ventilation and even blood transfusion.
How Does COVID-19 Affect Pregnancies?
From the women registered on the platform, 77 women had miscarriages,15 women had ectopic pregnancies (where the foetus was growing in areas other than the uterus); and 27 underwent medical termination of pregnancy (MTP). During the study period, deaths were not limited to still births or termination of pregnancies, 34 maternal deaths were also reported.
The researchers noticed that women older than 30 years of age were more severely infected than the pregnant women under the age of 30.
Even though the study found that close to 528 women delivered early, they could not ascertain if this was also found in women without COVID-19. As this finding did not have appropriate research control, the researchers believe that this needs to be studied further.
The fatality rate on the registry was found to be 0.8 per cent across the hospitals in Pune, Marathwada, Mumbai, Vidarbha, Khandesh. This was higher than other studies which tried to understand the impact of COVID-19 on pregnant and post- partum women using other registries. The fatality rate was higher than PAN-COVID (0.5 per cent) and AAP-SONPM (0.2 per cent) registries, but lower than the UK registry (1.2 per cent)
Women already living with other co-morbidities such as anaemia, diabetes mellitus, and tuberculosis were at a higher risk of progressing towards maternal deaths if infected by COVID-19.
