Pregnant women who contract the coronavirus are more at risk for severe illness and death than non-pregnant women, a Centers for Disease Control and Prevention (CDC) analysis found. The agency has previously warned that pregnant people might be at an increased risk for severe illness from COVID-19, but research is ongoing.
The new report, issued Monday, analyzed data collected from over 400,000 women ages 15-44 with symptomatic COVID-19.
Of the 409,462 women with symptomatic coronavirus, 23,434 were pregnant.
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“After adjusting for age, race/ethnicity, and underlying medical conditions, pregnant women were significantly more likely than were non-pregnant women to be admitted to an intensive care unit, receive ventilation, receive extracorporeal membrane oxygenation and die,” the report said.
The CDC said the findings may be due to the physiologic changes associated with pregnancy, including increased heart rate and oxygen consumption, decreased lung capacity, immunity changes and increased risk for thromboembolic disease.
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Separately, the analysis also found racial and ethnic disparities in both risks for infection and disease severity among pregnant women, “indicating a need to address potential drivers of risk in these populations,” the report said.
The health agency said pregnant women should be counseled about the importance of seeking prompt medical care if they develop symptoms of coronavirus, and that there should be a strong emphasis on coronavirus prevention for pregnant women at each medical appointment.
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“To minimize the risk for acquiring SARS-CoV-2 infection, pregnant women should limit unnecessary interactions with persons who might have been exposed to or are infected with SARS-CoV-2, including those within their household, as much as possible,” the CDC said. “When going out or interacting with others, pregnant women should wear a mask, social distance, avoid persons who are not wearing a mask, and frequently wash their hands.”
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The CDC also advised pregnant women stay up to date with flu shots and prenatal care.
Pregnant women infected with the coronavirus are more likely to become severely ill and die from Covid-19, and they’re at increased risk for premature delivery, according to a pair of reports released Monday by the US Centers for Disease Control and Prevention.
Although the overall risk of severe illness or death remains low, CDC researchers found that pregnant women with coronavirus are more likely to need intensive care, ventilation and heart and lung support than non-pregnant women with the virus.
A separate report found that the rate of preterm birth, when a baby is born before 37 weeks of pregnancy, is 12.9% among women with coronavirus, compared to 10.2% among the general population.
The new research adds to a growing body of evidence that pregnant women are at increased risk when it comes to coronavirus, said Dr. Denise Jamieson, chair of the gynecology and obstetrics department at Emory University School of Medicine.
“It also demonstrates that their infants are at risk, even if their infants are not infected, they may be affected,” Jamieson noted on a call with reporters Monday.
Increased risk for severe illness and death
For one of the reports, researchers reviewed data on 461,825 women between the ages of 15 and 44 who tested positive for Covid-19 between January 22 and October 3. They focused only on those who experienced coronavirus symptoms.
The team adjusted for outside factors and found that pregnant women were more likely to need intensive care, with 10.5 per 1,000 pregnant women admitted to the ICU, compared to 3.9 per 1,000 women who aren’t pregnant.
Pregnant women were 3 times more likely to need help breathing with invasive ventilation than women who aren’t pregnant. Similarly, they were at greater risk of requiring lung and heart support with oxygenation.
They were also more likely to die, with 1.5 deaths per 1,000 pregnant women, compared to 1.2 per 1,000 women who aren’t pregnant.
In keeping with trends seen across the general population, researchers found some racial and ethnic minorities had an even greater potential for infection or severe disease. Among pregnant women, Hispanic women were 2.4 times more likely to die and Asian and Native Hawaiian/ Pacific Islander women had a more pronounced risk for ICU admission, they found.
The team noted that regardless of whether they were pregnant, women over 35 were more likely to experience severe illness.
The researchers said that the greater probability for severe illness among pregnant women might be due to physiological changes in pregnancy, including increased heart rate and decreased lung capacity.
“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 symptoms and measures to prevent SARS-CoV-2 infection should be strongly emphasized for pregnant women and their families during all medical encounters, including prenatal care visits,” the team wrote.
Risk of preterm delivery and infant infection
Pregnant women with coronavirus infection were also more likely to deliver babies
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.
A recent story in The Washington Post reported on the more than 700 women who’d tested positive for the novel coronavirus and given birth at the BYL Nair Charity Hospital in Mumbai, India. The hospital is a part of a group called PregCovid, which collects data regarding pregnancy and COVID-19.
Here in the United States, health departments reporting cases of COVID-19 during pregnancy to the Centers for Disease Control and Prevention can provide additional information to help us understand its effects during this critical period in a woman’s – and her child’s – life. Yet despite the growing pool of data about the coronavirus, our understanding of the effects of COVID-19 on pregnant women remains limited, which is troubling given that many states are struggling with the pandemic and the high stakes involved for mothers.
While researchers continue to collect and interpret available data, it is important that pregnant women be especially vigilant to protect themselves and their babies, including by – at minimum – taking basic precautions such as practicing social distancing and wearing masks.
As an infectious disease physician who recently gave birth to my new daughter, being pregnant during the coronavirus pandemic posed significant challenges both physically and intellectually. In my field, we practice evidence-based medicine, but with the novel coronavirus, we continue to learn more each day and to update our recommendations based on new information. For now, the evidence indicates that the best tools to help contain the spread of COVID-19 are social distancing and mask-wearing.
As states have opened up and restrictions have been relaxed, however, people may believe that the risks posed by the coronavirus are diminished and go about their lives without taking these precautions. Doing so may be particularly dangerous for pregnant women: Data published in a CDC report just this week found that expectant mothers with symptomatic COVID-19 were more likely than other infected women to end up in the ICU, to require invasive ventilation and to die.
In addition, the coronavirus may cause poor pregnancy outcomes such as preterm birth. While the CDC may update its information as more becomes available, these possibilities are concerning.
Meanwhile, one of the growing hopes to prevent the coronavirus’ spread is a vaccine. Yet the release of one may not be a panacea for pregnant women, who have been excluded from clinical trials. Given this, it will take some time before we understand if these vaccines are safe for mothers and their babies, so pregnant women may be advised against getting a vaccine should one otherwise become available.
Expectant mothers who previously had COVID-19 also aren’t necessarily in the clear, as the current science is still evolving regarding immunity from COVID-19 once a person has recovered from the disease. Though rare, there have been cases of people reportedly becoming reinfected, and even a recent reported case of someone who died after reinfection.
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A vaccine against COVID-19 has been heralded, almost since the pandemic began, as the only way society will ever return to life as it was. In reality, though, challenges to widely distributing the vaccine, mistrust over how quickly it is being produced and limitations on who can receive it could mean the road to normalcy may actually be much longer.
Right now, there are four major U.S. pharmaceutical companies — Moderna, AstraZeneca, Johnson & Johnson and Pfizer — in late-stage clinical trials, where the vaccine is tested in tens of thousands of participants to assess both its efficacy and potential to cause adverse reactions. One of these vaccines, or more, could be available to high-risk populations by the end of the year, NBC News reported.
But in large part, these trials, the main process for assessing a vaccine’s safety, have left out two crucial groups that must be vaccinated to keep the coronavirus fully at bay: pregnant people and children.
So far, only Pfizer has received permission from the FDA to test on children. In September it started with those 16 and older; in October, it added kids as young as 12. There are, however, no plans to test any COVID-19 vaccines in pregnant women, who are more likely to get severely ill from COVID-19 than their non-pregnant counterparts, research shows.
“The sooner we can get a vaccine out to everybody, you can reduce transmission to everyone,” Dr. Yvonne Maldonado, a professor of pediatric infectious disease at Stanford University and member of the American Academy of Pediatrics’ Committee on Infectious Diseases, told TODAY. “As long as there are people out there who can spread it, we’re just not going to get rid of this pandemic.”
When will there be a COVID-19 vaccine for kids?
Nationwide, Pfizer has enrolled 100 kids between 12 and 15 and 200 between 16 and 17, Dr. Robert Frenck, director of the Vaccine Research Center at trial site Cincinnati Children’s, told TODAY via email. A Pfizer spokesperson said “several sites are now enrolling participants between the ages of 12 and 15,” as well.
In these trials, half of participants receive a placebo, and the other half receive the actual vaccine. The patients, doctors and nurses don’t know who received which in what’s called a double-blind study.
The plan is to recruit 2,000 kids between 12 and 15 for the Pfizer trial, and 600 total 16 to 17-year-olds, Frenck said, adding that researchers are looking for the same safety and immune response outcomes in kids as in adults. “If the immune response in kids is the same or better than in adults and if the vaccine is shown (to be) protective in adults, we will make the extrapolation that the vaccine should be protective in kids,” he explained.
Right now, the trial is in a “planned pause to review safety after the first dose of vaccine,” Frenck continued. Then researchers will decide on the timeline for bringing in more 12 to 15-year-olds.
Frenck said he
Sadie Robertson is on the mend after contracting the coronavirus.
On Monday, the Duck Dynasty alum, 23, shared a photo from her hospital bed, revealing in her caption that “one of the most challenging things” she has faced as of late has been her battle with COVID-19, which made her “very sick.”
“I know everyone experiences covid differently, but wow these symptoms are wild. I’ve definitely struggled through this one!” she wrote. “Thankfully baby Huff is doing great and healthy, and I am now healing as well. I’m no longer in the hospital (this pic was not from today) and I have just about fully recovered.”
Robertson, who is currently expecting her first child with husband Christian Huff, was diagnosed with coronavirus earlier this month.
“I’ve learned a lot and I have been challenged in a lot of new ways,” she said. “I will say my dependency on Jesus has never felt greater in some of the hardest moment of this sickness. I’m thankful I serve a savior who is with me in these moments that feel rather lonely. My heart and my [family’s] heart goes out to everyone suffering with Covid.”
Related: Sadie Robertson expecting first child with husband
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As the coronavirus continues to spread in the United States, many pregnant women are wondering what they can do to stay as safe as possible and limit their potential for exposure.
In an advisory on their website, the American College of Obstetricians and Gynecologists (ACOG) recommends expectant mothers to be extra vigilant about following existing precautions, as “available data suggest that pregnant women with COVID-19 may be at increased risk for more severe illness compared with nonpregnant peers.”
While “No increase in the rate of mortality has been noted,” the group says that “these data indicate an elevated risk of [intensive care unit] admissions and mechanical ventilation.”
“Pregnant patients with comorbidities such as obesity and gestational diabetes may be at an even higher risk for severe illness consistent with the general population with similar comorbidities,” the ACOG adds.
Huff and Robertson shared their pregnancy news Oct. 4, on their respective Instagram accounts. “SCREAMING WITH EXCITEMENT TO SHARE THIS NEWS! Baby we already adore you,” the mom-to-be captioned a photo of the pair cuddled up on the couch and showcasing their sonogram, in part.
The couple opened up Wednesday on Robertson’s WHOA That’s Good Podcast about learning the good news, with Huff, 22, saying they weren’t “not trying.” Noted Robertson, “I guess we shouldn’t have been that surprised, but we were super surprised and so I didn’t think I was pregnant at all.”
After she found herself “ravenous” all day and had a vivid dream about being pregnant (with a son!),
Opioid use in pregnancy has prompted new guidance from the American Academy of Pediatrics aimed at improving care for women and for newborns affected by their mothers’ drug use.
The number of affected women and infants has increased in recent years but they often don’t get effective treatment, and the coronavirus pandemic may be worsening that problem, said Dr. Stephen Patrick, lead author of the academy report released Monday.
“While we have been talking about the opioid crisis for years, pregnant women and their newborns seldom make it to the top of the heap. Infants are receiving variable care and not getting connected to services,” said Patrick, a Vanderbilt University pediatrician.
The academy’s report says pregnant women should have access to opioid medication to treat opioid misuse. Two opioids, buprenorphine and methadone, are effective treatments but pregnant women often face stigma in using them and doctors who prescribe them are scarce.
The academy says hospitals should have written protocols for assessing and treating opioid-affected newborns. Many don’t and practices vary widely.
Breastfeeding and other practices that promote bonding should be encouraged, and parent education and referral to services for affected newborns should be provided, the academy says. Its recommendations echo guidance from other medical groups and the U.S. government.
“This is a substantial public health problem that is still lacking solutions,” Patrick said.
According to the federal Centers for Disease Control and Prevention, 7% of U.S. women reported in 2019 that they had used prescription opioids during pregnancy. One-in-five of those women reported misusing the drugs while pregnant.
Some infants born to these women develop symptoms of opioid withdrawal, including tremors, fussiness and diarrhea.
By some U.S. estimates, nearly 80 affected infants are diagnosed every day and the numbers have tripled in recent years.
Patrick has done research suggesting that these infants may be at risk for developmental delays but says it’s possible those findings reflect use of alcohol or other drugs during pregnancy, poor prenatal care or stress.
“Getting into treatment may be getting even harder” because of the pandemic, he said. “There’s so much going on in the world that that issues involving opioid use are flying under the radar.”
A 28-year-old pregnant woman who ran a mile in less than six minutes is showing that pregnancy has no limits.
Makenna Myler, who runs with the Valor Track Club in Orange County, California, ran one mile last week in five minutes and 25 seconds, and she did it while nine months pregnant.
Her husband, Mike, captured the feat on video and shared it on TikTok, where it has gone viral with tens of thousands of likes, comments and shares.
“I think pregnancy is a beautiful thing and it’s not an injury or a sickness, that you’re still really capable,” Myler, who ran track at Brigham Young University, told “Good Morning America.” “I think a lot of women are showing that, that women are capable and that’s what matters.”
Myler said she and her husband, whom she describes as her biggest supporter, jokingly bet each other $100 that she would not finish the mile in under eight minutes, a bet Myler clearly won.
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Myler, whose due date was Oct. 19, said that while her sub-six minute mile is getting attention, she doesn’t want other women to think her training during pregnancy has been a breeze.
“The first trimester I didn’t have that extra weight but I was exhausted and I was probably running slower than I am now,” she said. “I’ve had to listen to my body and really let myself recover and get a workout in if I can, if my body is feeling it, but they’re definitely few and far between.”
Myler added of her approach to workouts, “When people say, ‘What are you going to run this time?’ I say, ‘Whatever my body wants.’ If I don’t want to do it, I’m not going to do it, because pregnancy and my health obviously comes first.”
And while most women will not run nearly five-minute miles, the workout done by Myler, who has dreams of representing the United States in the Olympics, is a safe one, experts say.
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“For my patients, in general, I tell them that they can continue doing anything that they were doing before pregnancy as long as it remains comfortable and doesn’t cause any pain,” said Dr. Danielle Jones, a board-certified OBGYN in College Station, Texas, who is not involved in Myler’s treatment. “You don’t see it a lot because most people get uncomfortable by the third trimester and aren’t wanting to run a five-minute mile, but there’s definitely people out there who can comfortably continue that in their pregnancy.”
Jones stressed that there are conditions that prevent women from exercising during pregnancy and that women should always consult with their doctors throughout their pregnancies and keep them informed of their exercise routine.
For pregnant women who are
The WHO initially recommended using acetaminophen instead of ibuprofen to treat coronavirus symptoms, but they have now said otherwise.
Some of the most commonly used pain and fever medications could be harmful to pregnant women and their unborn babies, the U.S. Food and Drug Administration announced Thursday.
The agency is requiring labeling changes for non-steroidal anti-inflammatory drugs (NSAIDs) to explain that if women take these medications at about 20 weeks or later into their pregnancy, they can cause fetal kidney problems.
NSAIDs include both prescription and over-the-counter drugs such as ibuprofen and naproxen, commonly known by the brand names Advil and Aleve. It also includes diclofenac, celecoxib and aspirin above 81 mg.
According to the FDA, these medications work by blocking the production of a certain chemical in the body that causes inflammation.
“It is important that women understand the benefits and risks of the medications they may take over the course of their pregnancy,” said Dr. Patrizia Cavazzoni, acting director of the FDA’s Center for Drug Evaluation and Research.
Fetal kidney problems can lead to other pregnancy-related complications as the kidneys are responsible for producing amniotic fluid, the protective cushion surrounding the baby.
Fetuses produce the most amniotic fluid beginning about 20 weeks after conception, and kidneys damaged by NSIADs could result in low levels of amniotic fluid, reducing a baby’s protection inside the mother’s womb.
Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, said low levels of amniotic fluid also could cause problems with the baby’s development.
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Doctors can detect a decrease in amniotic fluid levels as soon as two days after taking these medications, the FDA said, but levels usually return to normal after a pregnant women stops taking them.
The agency recommends pregnant women avoid NSAIDs after 20 weeks and opt for other medicine to treat pain and fever during pregnancy, such as acetaminophen.
Wu said taking ibuprofen and other NSIADs in the third trimester also could cause heart problems in the baby.
“When you’re pregnant, your baby is exposed to every medication you’re taking,” Wu said. “So, you need to be careful and check with your health care provider before taking any medications, including over the counter medications.”
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