Pregnant women less likely to get COVID-19, but more likely to have severe outcomes
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LISBON, Portugal — Compared with their nonpregnant, reproductive-aged counterparts, pregnant women were less likely to acquire COVID-19 but were significantly more likely to be hospitalized or admitted to an ICU when they did.
The findings, presented at the European Congress of Clinical Microbiology and Infectious Diseases, add to existing research showing the adverse outcomes of SARS-CoV-2 infection in pregnancy.
“Pregnant individuals are a special population in relation to disease,” Kiera Murison, BScH, an MPH epidemiology student in the Dalla Lana School of Public Health at University of Toronto in Canada, told Healio. “These individuals undergo physical changes that impact the immune system, as well as the respiratory system, which can make them more susceptible to illness. As we know, COVID-19 has the ability to challenge these changes.”
Using a population-based SARS-CoV-2 case file from Ontario, Canada, Murison and colleagues time-matched women aged 10 to 49 years to compare the risk for hospitalization and ICU admission in pregnant and nonpregnant women.
Data showed that nonpregnant women had a higher risk for infection compared with the base population, and pregnant women had a lower risk (incidence rate ratio = 0.47; 95% CI, 0.45-0.49).
“It was somewhat surprising to find that pregnant people were about half as likely to be infected as the general population,” Murison said. “An even greater discrepancy was seen between pregnant individuals and nonpregnant women of child-bearing age, who were at an increased chance of infection compared to the general population.”
However, when adjusting for age, comorbidity, health care worker status, vaccination and SARS-CoV-2 variant, pregnant women had a significantly increased risk for hospitalization (adjusted OR = 4.96; 95% CI, 3.86-6.37) and admission to an ICU (aOR = 6.58; 95% CI, 3.29-13.18).
“We hope that our work can provide evidence for COVID-19 vaccination when being considered by pregnant individuals and their care providers,” Murison said.
Murison suggested researchers continue to investigate the immunity of newborns of vaccinated mothers regarding disease variants.
Perspective
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The team from University of Toronto presented data from a matched cohort analysis, investigating the question of severity of COVID-19 in pregnancy in Ontario in the beginning of the pandemic. Indeed, initially it appeared that pregnant women did not seem to fare worse than nonpregnant women. However, what the team showed was that although pregnant women did not come down with COVID-19 as readily as nonpregnant women, the outcomes — including hospitalization and ICU admission — for the gravidas were significantly worse. This is certainly evident in the emerging recognition of the development of severe preeclampsia in SARS-CoV-2-infected women. Their take home message is quite clear: Given the benignity of COVID-19 vaccinations among pregnant women, all pregnant women should vaccinate.
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Murison K. Abstract L0401. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; April 23-26, 2022; Lisbon, Portugal (hybrid meeting).
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