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COVID-19 may double risk of severe complications in pregnancy, according to new study



Pregnant patients who tested positive for the coronavirus had more than double the risk of poor outcomes than patients who did not test positive for the virus, according to a new study.Conducted by Kaiser Permanente in Northern California, the study looked at 43,866 pregnant individuals who delivered between March 2020 and March 2021, of whom 1,332 had a coronavirus infection during their pregnancy. Notably, the time period that was studied took place before vaccines against the virus were available to the general population.The patient population was racially and ethnically diverse, with 33.8% white, 28.4% Hispanic or Latino, 25.9% Asian or Pacific Islander, 6.5% Black, 0.3% American Indian or Alaska Native, and 5% multiracial or unknown race and ethnicity.Poor outcomes included preterm birth, venous thromboembolism (blood clot), and severe maternal morbidity. Severe maternal morbidity is a composite outcome that includes 21 severe conditions occurring during pregnancy, the most frequent in patients who tested positive for the coronavirus being acute respiratory distress syndrome and sepsis The study found twice the risk for preterm birth for those testing positive for coronavirus. COVID-positive patients were also three times more likely to suffer a blood clot and 2 1/2 times more likely to have a severe maternal morbidity.Dr. Assiamira Ferrara, the lead author of the study, said she was not surprised by the findings, particularly regarding preterm births and blood clots.”Given prior evidence of other infections and various inflammatory cytokines leading to preterm birth, the association between SARS-CoV-2 infection and preterm birth was physiologically plausible,” Dr. Ferrara, a senior research scientist and associate director at Kaiser, said.”COVID-19 is associated with abnormal coagulation profiles,” Dr. Ferrara continued. “This is a serious concern for pregnant patients since pregnancy is associated with a hypercoagulable state, which might be exacerbated by SARS-CoV-2 infection.”Coagulation refers to the process by which blood turns from a liquid to a gel-like consistency, forming a blood clot. Dr. Ferrara also added that pre-existing conditions “did not have an effect on the differences in perinatal complications between the people with positive tests and those without.”As for variants, the study was conducted well before omicron, and most likely before delta was prevalent in the U.S. Dr. Ferrara said that other studies, though, have shown that the variants could increase the risk in pregnant patients.”Some recent studies have reported that pregnant women with a SARS-CoV-2 infection during the time the delta variant was predominant were more likely to die or need mechanical ventilation than women with a SARS-CoV-2 infection before the delta variant became predominant,” she said.Dr. Ferrara said one of the most important takeaways from this study should be the importance of pregnant individuals getting vaccinated.”People planning a pregnancy and pregnant patients can maintain their health in many ways, and now we can add vaccination against COVID-19 as one of the most important,” she said. “Other research has shown that vaccination during pregnancy is safe.”

Pregnant patients who tested positive for the coronavirus had more than double the risk of poor outcomes than patients who did not test positive for the virus, according to a new study.

Conducted by Kaiser Permanente in Northern California, the study looked at 43,866 pregnant individuals who delivered between March 2020 and March 2021, of whom 1,332 had a coronavirus infection during their pregnancy.

Notably, the time period that was studied took place before vaccines against the virus were available to the general population.

The patient population was racially and ethnically diverse, with 33.8% white, 28.4% Hispanic or Latino, 25.9% Asian or Pacific Islander, 6.5% Black, 0.3% American Indian or Alaska Native, and 5% multiracial or unknown race and ethnicity.

Poor outcomes included preterm birth, venous thromboembolism (blood clot), and severe maternal morbidity.

Severe maternal morbidity is a composite outcome that includes 21 severe conditions occurring during pregnancy, the most frequent in patients who tested positive for the coronavirus being acute respiratory distress syndrome and sepsis

The study found twice the risk for preterm birth for those testing positive for coronavirus. COVID-positive patients were also three times more likely to suffer a blood clot and 2 1/2 times more likely to have a severe maternal morbidity.

Dr. Assiamira Ferrara, the lead author of the study, said she was not surprised by the findings, particularly regarding preterm births and blood clots.

“Given prior evidence of other infections and various inflammatory cytokines leading to preterm birth, the association between SARS-CoV-2 infection and preterm birth was physiologically plausible,” Dr. Ferrara, a senior research scientist and associate director at Kaiser, said.

“COVID-19 is associated with abnormal coagulation profiles,” Dr. Ferrara continued. “This is a serious concern for pregnant patients since pregnancy is associated with a hypercoagulable state, which might be exacerbated by SARS-CoV-2 infection.”

Coagulation refers to the process by which blood turns from a liquid to a gel-like consistency, forming a blood clot.

Dr. Ferrara also added that pre-existing conditions “did not have an effect on the differences in perinatal complications between the people with positive tests and those without.”

As for variants, the study was conducted well before omicron, and most likely before delta was prevalent in the U.S. Dr. Ferrara said that other studies, though, have shown that the variants could increase the risk in pregnant patients.

“Some recent studies have reported that pregnant women with a SARS-CoV-2 infection during the time the delta variant was predominant were more likely to die or need mechanical ventilation than women with a SARS-CoV-2 infection before the delta variant became predominant,” she said.

Dr. Ferrara said one of the most important takeaways from this study should be the importance of pregnant individuals getting vaccinated.

“People planning a pregnancy and pregnant patients can maintain their health in many ways, and now we can add vaccination against COVID-19 as one of the most important,” she said. “Other research has shown that vaccination during pregnancy is safe.”



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