CDC: Pregnant women with COVID-19 have higher risk for preterm birth
Nov. 2 (UPI) — Pregnant women infected with COVID-19 are about 25% more likely to deliver their babies preterm, according to data released Monday by the U.S. Centers for Disease Control and Prevention.
About 13% of babies born to mothers with the disease were delivered preterm, or at less than 37 weeks, the data showed.
Just over 10% of babies in the United States are born preterm, according to the CDC.
“The proportion of preterm live births among women with [COVID-19] infection during pregnancy was higher than that in the general population in 2019, suggesting that pregnant women with [the disease] infection might be at risk for preterm delivery,” agency researchers wrote.
Still, the findings are “preliminary and describe primarily women with second and third trimester infection, and … subject to change pending completion of pregnancy for all women in the cohort,” they said.
For the analysis, the CDC researchers reviewed data on pregnancy and infant outcomes among 5,252 women with laboratory-confirmed COVID-19 from 15 states and Puerto Rico reported between March 29 and Oct. 14.
Among 3,912 live births with known gestational age, 12.9% were preterm, the agency said.
However, fewer than 3% of infants for whom test results were available had evidence of the virus, and most of them were born to mothers who had been infected within one week of delivery, the agency said.
Among 610 infants with reported test results, 2.6% tested positive for COVID-19, the data showed.
Previous studies have shown that pregnant women are unlikely to pass the disease on to their children.
However, data released by the CDC in June indicated that expecting mothers may be at increased risk for severe illness from the virus.
These concerns appear to have been confirmed in a separate analysis the agency released Monday, which found that pregnant women infected with COVID-19 were more than twice as likely to require treatment in a hospital intensive care unit and nearly three times as likely to need mechanical ventilation than “non-pregnant” women.
However, “the absolute risks for severe outcomes for women were low,” according to the CDC.
“Pregnant women were at increased risk for severe COVID-19-associated illness,” the CDC researchers said.
“To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptom sand measures to prevent [coronavirus] infection should be strongly emphasized for pregnant women and their families,” they said.
Phoenix Indian Medical Center birth center closes, upsets moms-to-be
Rochelle Chee and her son, Theodore. (Photo: Courtesy of Rochelle Chee)
For months, Rochelle Chee diligently went to the Phoenix Indian Medical Center for prenatal checkups.
She knew a midwife and other staff there well and felt confident in the idea of going to the facility to deliver her first baby, who was growing big, in the 90th percentile for his gestational age.
That’s why the Navajo woman was shocked when, at 40 weeks pregnant, she learned the hospital had shut down its obstetrics services with no prior notice.
“I was stressed the whole time as I have been seeing PIMC throughout my whole pregnancy and last minute, I had to go elsewhere,” said Chee, 30. “My baby and I felt abandoned.”
The sudden closure of the Phoenix Indian Medical Center obstetrics, or OB-GYN, services on Aug. 26 has left dozens of expectant moms like Chee scrambling to seek birthing services elsewhere — and some facing unexpected, steep costs. Some say they’ve received conflicting explanations and unclear guidance on what to do next.
The federal Indian Health Service said in an email Friday to Indian Country Today that the closure is temporary and related to “facility infrastructure, equipment and challenges with staffing.” It did not provide a reopening date.
“PIMC is working to resume obstetrical services when they can be provided in a safe environment,” the statement read.
The hospital continues to provide prenatal and gynecologist specialty care, and facilitate care for patients near term, the agency said.
“Patient safety is the highest priority for the Indian Health Service.” It did not answer questions about how it’s advising expectant mothers who rely on its birthing services.
‘Unsafe conditions’
The Phoenix Indian Medical Center, near downtown, provides health care and community health services to more than 140,000 people from the greater Phoenix area. “The tribal identity of eligible beneficiaries receiving care at PIMC is representative of 67 percent of the 573 federally recognized tribes,” its website says.
The hospital operates under the Indian Health Service umbrella, providing care to tribal citizens under a federal obligation to Native people.
It has offered prenatal and birthing services for decades.
The Phoenix Indian Medical Center went weeks without publicly announcing the closure and referred all questions to the Indian Health Service, which did not provide details on how many patients were affected.
However, a source familiar with the hospital’s inner workings said nearly 200 patients have been referred out in recent weeks. The person was not authorized to speak publicly and spoke to Indian Country Today only on condition of anonymity.
The decision to close the obstetrics services was abrupt and made by the PIMC Governing Board in response to an internal review that recommended closure due to “unsafe conditions,” the source said.
In its statement, the Indian Health Services noted aging facilities and said its Phoenix area office has started a master planning
Birth asphyxia: Causes, symptoms, and treatment
Birth asphyxia is a condition in which a baby does not receive enough oxygen before, during, or directly after birth.
In severe cases, it can cause serious complications and even be life threatening. Immediate treatment is necessary to ensure that the baby receives enough oxygen.
In this article, we look at the causes and symptoms of birth asphyxia, as well as the potential complications, treatment, and prevention.
Other names for birth asphyxia include perinatal asphyxia and neonatal asphyxia.
Birth asphyxia occurs when an infant does not receive enough oxygen when born, potentially leading to difficulty breathing. It can happen just before, during, or after birth.
Insufficient oxygen supply to the body can cause low levels of oxygen or a buildup of excess acid in the baby’s blood.
These effects can be life threatening and require immediate treatment.
In mild or moderate cases, babies may recover fully. However, in severe cases, birth asphyxia can cause permanent damage to the brain and organs or be fatal.
Birth asphyxia rates are lower in developed countries, with a rate of 2 in 1,000 births. In areas of developing countries where there is limited access to neonatal care, this rate increases up to 10 times.
A variety of factors can cause birth asphyxia. These can relate to the pregnant person or the fetus, and they include:
- Umbilical cord prolapse: This birth complication occurs when the umbilical cord leaves the cervix before the baby.
- Compression of the umbilical cord
- Meconium aspiration syndrome: This syndrome occurs when a baby inhales a mixture of amniotic fluid and meconium, their first feces.
- Premature birth: If a baby is born before 37 weeks, their lungs may not yet be fully developed, and they may be unable to breathe properly.
- Amniotic fluid embolism: Although rare, this complication — in which amniotic fluid enters the pregnant person’s bloodstream and causes an allergic reaction — is very serious.
- Uterine rupture: Research has shown a significant association between tears in the muscular wall of the uterus and birth asphyxia.
- The placenta separates from the uterus: This separation can happen before the birth.
- Infection during labor
- Prolonged or difficult labor
- High or low blood pressure in pregnancy
- Anemia: In a baby with anemia, the blood cells are not carrying enough oxygen.
- Not enough oxygen in the pregnant person’s blood: The level of oxygen may be insufficient before or during birth.
Risk factors for birth asphyxia include:
- the pregnant person being between the ages of 20 and 25 years
- multiple births, such as delivering twins or triplets
- not attending prenatal care
- low birth weight
- abnormal position of the fetus during delivery
- preeclampsia or eclampsia
- history of birth asphyxia in a previous birth
Signs and symptoms of birth asphyxia can occur before, during, or just after birth. Before birth, a baby might have an abnormal fetal heart rate or low blood pH levels, which indicate excess acid.
Signs in the baby at birth can indicate a lack of oxygen or blood flow. They include:
- unusual skin tone
Severe Morning Sickness Linked to Depression Before and After Birth | Health News
By Robert Preidt, HealthDay Reporter
(HealthDay)
FRIDAY, Oct. 16, 2020 (HealthDay News) — Women who suffer severe morning sickness may have higher risk of depression during and after pregnancy, according to a new British study.
It enrolled 214 women in London during the first trimester of pregnancy. Half had severe morning sickness; half did not. None had been treated for mental health conditions during the previous year.
The women’s mental health was assessed in their first trimester and six weeks after giving birth.
Nearly half of the women with severe morning sickness had depression in the first trimester and nearly 30% had depression after delivery. Among the women without morning sickness, the rates were 6% and 7%, respectively.
Half of the women with severe morning sickness had to take four or more weeks off work during or after pregnancy, according to findings published Oct. 14 in the journal BMJ Open.
Severe morning sickness, also known as hyperemesis gravidarum, is one of the most common reasons for hospitalization during pregnancy. Women with the condition are often severely nauseated with persistent vomiting. They can be bedridden for weeks, suffer dehydration and weight loss, and often can’t work or care for their other children.
But lead author Dr. Nicola Mitchell-Jones, a specialist registrar in obstetrics and gynecology at Imperial College London, said many health care providers don’t take the mental health impact of severe morning sickness seriously enough.
Women with severe morning sickness are about eight times more likely to suffer depression before giving birth and four times more likely to be depressed afterward, she said.
“Some women in the study even had thoughts of self-harm whilst suffering HG [hyperemesis gravidarum],” Mitchell-Jones said in a college news release. “These figures are shocking and should be reflected in the treatment women receive. We need to do much more than simply treat the physical symptoms of HG; assessment for mental health support should also be routine for any woman with the condition.”
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