We would like to comment briefly on a recent report from the Centers for Disease Control and Prevention (CDC) about COVID-19 and pregnancy. The report—covered by the major media—stated that pregnant women with COVID-19 infections were more likely to be admitted to the hospital, require ICU care, and require mechanical ventilation (a respirator) than women who are not pregnant.
Of course, we advise our pregnant patients to take the recommended precautions to avoid contagious illnesses—including COVID-19. But we are concerned that this report creates stress and anxiety for our expectant mothers that far outweighs the quality and value of the data.
Until now, obstetricians have generally cautioned their patients that they are at higher risk for serious complications of flu and other respiratory illnesses during pregnancy. Pregnancy may cause a woman’s immune system to be less effective. For example, pregnant women with H1N1 (swine flu) were about 7 times more likely than others to require intensive care. During the swine flu pandemic, pregnant women were about 5% of all deaths—though they are only about 1% of the population. As COVID-19 spread over the past months, we have been very pleased that this new virus did not seem to be more dangerous during pregnancy. The new CDC report suggests otherwise.
We appreciate that our professional organization, the American College of Obstetricians and Gynecologists (ACOG) has stepped forward to critique some of the statements in the CDC report. From ACOG: “…these new data have several key limitations…”.
Your physicians here at Sparks & Favor would like to reassure you by pointing out some problems with the CDC report.
- The CDC report states that more pregnant than non-pregnant women with COVID-19 were admitted to the hospital. But the statistic INCLUDES WOMEN WHO WERE ADMITTED ONLY BECAUSE THEY WERE IN LABOR—who required no care at all for COVID illness. All pregnant COVID patients eventually get admitted to the hospital to deliver a baby!
- While reporting that more pregnant women required ICU care and more required mechanical ventilation than non-pregnant women, the statistics do not specify whether the need for critical care had anything to do with COVID illness. Pregnancy and childbirth always carry certain risks for the mother. Preeclampsia (high blood pressure during pregnancy), diabetes and gestational diabetes, hemorrhage during childbirth, blood clots, and other conditions can present life-threatening situations. A woman’s risk of a blood clot, for example, is 10 times higher during pregnancy. Modern obstetric care has greatly reduced maternal risk. But pregnancy can still present unique medical risks having nothing to do with COVID-19. Since the CDC data did not track whether the need for intensive care was COVID-related or only pregnancy-related, it is our opinion that the report does little to advance our understanding of whether COVID is more serious during pregnancy.
Overall, the risk of more serious outcomes for COVID-19 illness during pregnancy is very low, significantly lower than with H1N1 flu. Death rates for pregnant women are NOT higher than for non-pregnant women of childbearing age. Research contains some case reports that COVID-19 may have passed to an unborn baby, but this appears very rare.
At this point, we don’t feel there is enough good-quality research to say that pregnancy is a special COVID-19 risk group. We don’t want incomplete information to contribute to your stress and anxiety during this pregnancy. We especially don’t want anxiety about COVID illness to cause a woman to avoid prenatal care or avoid coming to the hospital for a medical emergency or for her delivery. We advise you to follow the recommended precautions for masking, social distancing, and hand washing that you would follow if you were not pregnant.
Best wishes for the joyous time ahead from your physicians at Sparks & Favor!