COVID-19 and Pregnancy – What Are the Risks?

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Samantha Shatz

While we have been living with the global pandemic for over a year, researchers continue to explore the effects, including the long term consequences, of COVID-19 and pregnancy.

Most recently, the Journal of the American Medical Association published a study entitled Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection. This multinational study involved 2,130 women from 18 different countries and examines the risks of both maternal and neonatal outcomes when a mother contracts COVID-19, by comparing groups of woman infected with the virus, to those who did not contract the virus. The participants, including the neonates, were followed up until hospital discharge. The study took place from March 2020 to October 2020.

The study indicates that pregnant individuals who contract COVID-19 and exhibit symptoms, are more likely to require hospitalization, including ventilation. Pregnant individuals who contracted COVID-19 were also more likely to experience adverse outcomes such as preeclampsia, which is a severe and potentially life threatening pregnancy complication that impacts the internal organs. Studies report that adverse outcomes were more likely to occur in women with co-morbidities such as obesity, asthma or diabetes. The risk of maternal mortality was 1.6% or 22 times higher in the group of women with COVID-19. It is important to note that these deaths were mostly occurring in institutions located in less developed regions, implying that when high quality ICU services are not available, COVID-19 in pregnancy can be lethal.

There have been some reports that pregnant individuals with COVID-19 are at risk of pre term labour and still birth. While high fevers and severe respiratory infections can impact fetal wellbeing, there is limited research at this time on the precise effect of COVID-19 on a fetus. There has also been some suggestion that COVID-19 can be transferred to a fetus but this appears to be quite rare.

Vaccinations

In Ontario, pregnant individuals were recently included as a priority group to receive vaccinations. This decision followed a call to action from the Society of Obstetricians and Gynaecologists of Canada to the Federal Government after reports of increasing numbers of pregnant individuals being admitted to Canadian ICUs.

Reports have indicated that vaccinations are both effective and safe when administered to pregnant individuals. The Society of Obstetricians and Gynaecologists of Canada (SOGC) released a consensus statement regarding COVID-19 vaccination in pregnancy. In summary, the statement recommends the following:

  1. Pregnant individuals should be offered vaccination at any time during pregnancy or while breastfeeding if no contraindications exist.
  2. The SOGC supports the use of all available COVID-19 vaccines approved in Canada in any trimester of pregnancy and during breastfeeding in accordance with regional eligibility.
  3. The decision to be vaccinated is based on the individual’s personal values, as well as an understanding that the risk of infection and/or morbidity from COVID-19 outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding. Individuals should not be precluded from vaccination based on pregnancy status or breastfeeding.
  4. Given that pregnant people are at increased risk of morbidity from COVID-19 infection, all pregnant persons should be eligible to receive a COVID-19 vaccination.

Safety Protocols to Consider

If you believe you have become infected with COVID-19, you should contact your health care provider as soon as possible. It is recommended that you get tested for the virus and discuss treatment options with your health care provider which may include the use of medication for relief of symptoms such as fever and cough.

At Howie, Sacks & Henry, we have extensive experience helping clients to understand and navigate the complex medical malpractice and birth injury claims process. If you have concerns about the obstetrical care you or a loved one have received, if you believe your infant suffered harm during the birth process, we want to help — please contact Samantha Shatz at 647-796-0086 or SShatz@hshlawyers.com.


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