Covid-19 in Pregnancy & Why You Shouldn't Worry

Three years on and the information on covid-19 is still changing with the ebb and flow of time and variants. What hasn’t changed is a woman’s desire to know the truth about contracting this virus during pregnancy without all of the emotions and opinions that come from her decision to vaccinate or not.

When it comes to trustworthy information, it’s a little scary scouring the internet if you’re not sure where to look and how to analyse what makes a study reasonable and trustworthy, because believe me, there are studies with lots of bias or limited data.

Luckily for you, BirthTools™ is here to break down the most relevant studies and relied upon information as it ever changes.

A little side note: BirthTools™ supports freedom of choice when it comes to vaccination decisions and respects a mother's right to make her own choices. We aim to provide unbiased information in this article for that purpose.

Should I be worried if I get covid while pregnant?

You may have heard that women who are pregnant are at higher risk for the more severe sides of SARS-CoV-2. What this doesn’t mean is that if you contract covid and your pregnant, your symptoms will be worse. It is simply that you are more vulnerable to the more difficult side effects like intensive care admission, respiratory support, and pneumonia. Another piece of good news is that evidence seems to point pregnant women are not more susceptible to the virus than non-pregnant women (Stock et al, 2022)

From the information that has been analysed on a repeated basis by Evidence Based Birth (you can sign up to their newsletter updates here), it seems that if you’re unvaccinated, you may get the raw end of the stick. A large, population-based study from Scotland began in December 2020 and ended before booster’s were readily available. It was published last year and researchers looked at 87,964 pregnant people of which 4,950 women had covid. 
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This are the results they found:

  • 77.4% of those that tested positive were unvaccinated

  • 5.1% of vaccinated women were admitted to the hospital
  • 19.5% of unvaccinated pregnant women were admitted to the hospital

Out of those women, those that needed critical care was 0.2% (vaccinated) and 2.7% (unvaccinated).


At the time of publishing this study there had been 1 maternal death following SARS-CoV-2 infection in pregnancy in Scotland (Stock et al, 2022).

When did pregnant women need to go to hospital?

In another UK study, a national data system was analysed to assess what kind of symptoms and treatment pregnant women were having to undergo to recover during the omicron outbreak. This type of study is called a prospective cohort study and looked at 94 hospitals and looked at any admission if you were pregnant and tested positive during a three month span (Dec 21 – Mar 22).

The study found that 3699 women were admitted to hospital but only 986 had symptoms that were documented. The treatment and symptoms ranged from mild to more serious.
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99 women needed respiratory assistance

77 of these were non-invasive oxygen masks eg; nasal canulae

7 required a higher flow of oxygen

12 needed more invasive and intensive respiratory support

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Overall in the entire period 4 women passed away, seemingly as a result of SARS-CoV-2 infection (Vousden et al, 2022).

That’s a lot of numbers and I hope I made it simple for you. The links to all of the research is below, if you would like to dive a little bit deeper. The next question on your lips is, "what effect your covid-19 diagnosis may have on your pregnancy and baby?"

What are the effects of covid on an unborn baby?

Well, at as stated before, just because you test positive for the virus, doesn’t mean you and your baby need to worry too much. Although yes there are some concerns, they aren’t a definite or highly likely.When it comes to your baby or babies, there are three main concerns that doctors may discuss:

Pre-Term Birth
Preeclampsia
Perinatal death (stillbirth and loss within 28 days of birth)

Is Covid linked to Premature Birth?

Two of the studies mentioned noted that when it came to pre-term birth, it was more common to happen within 28 days of contracting the virus. That being said, the numbers of early birth were quite low if babies were in the first two trimesters of pregnancy and began to climb as your babies became more mature.

This means, that even if women with SARS-CoV-2 infection are at risk for their baby joining them earthside a little early, it’s not as early as you may think *phew*

During this three month study, out of all the women who had details of their birth (2963) & contracted covid during pregnancy, pre term birth was still more likely to occur in the mid third trimester. Hopefully this fills you with a bit of relief!
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I’ve summarized the findings of when babies were more likely to be born by gestational week from the study and compared it to the weeks of birth for Australian women during the year 2019 to give you a very general comparitive guide (Mothers & Babies, 2020).
Gestatation at Birth for Covid Positive Women
0.6%

22 weeks to
27+6 weeks

an increase from 0.7% for 2019

2.3%

28 weeks to
33+6 weeks

an increase from 0.6% for 2019

8.6%

34 weeks to
36+6 weeks

an increase from 6.1% for 2019

87.9%

37 weeks
onwards

a decrease from 91.8% for 2019

As you can see there is a higher risk of preterm birth for your baby if you had covid in your pregnancy but the numbers aren’t astronomical when comparing the unavoidable fact that some babies do come early with or without the virus for many unknown reasons. It is also important to note that women that were both asymptomatic and symptomatic are included in these results.


What about Covid and Pre-eclampsia?

When it comes to the concern for preeclampsia the risk of developing it was 1.58 times higher in the COVID-19 group as compared to the pregnant people without COVID-19. This was derived from a review of 28 different studies in 2021, made up of 790,954 pregnant people, 15,524 of which were diagnosed with COVID-19 (Agustin et al, 2021).


Is there an increase in Stillbirth with Covid?

Lastly when it comes to the wellbeing of your baby just before birth and within the first 28 days, it seems that if you are unvaccinated your baby is more at risk of death. Although the studies aren't able to categorically state whether it is in direct correlation to a mother having contracted covid-19.

In order to get the numbers I am referring back to the large study conducted in Scotland over the period from Dec 2020 until just before boosters became available and recommended. They found that there were 19 deaths out of 2,364 births and it was all in the unvaccinated group. There were zero perinatal deaths among the vaccinated and infected group.

To put this into context for you, even though they are two different countries they have similar maternity outcomes, Australia’s perinatal death rate in 2020 was 9.1/1000 for all pregnant women.

Based on these numbers, there is minimal to no change in perinatal outcome as the statistic for unvaccinated women lies at 8/1000 babies.

The only interesting piece of information was that 14 of the 19 deaths occurred within 28 days of active infection, but there is no information on whether these women had birth complications outside of covid-19 as the data wasn’t available.

So what's the takeaway?

  • You are not more likely to get covid just because you're pregnant
  • If you do test positive, you're symptoms won't always be worse than non pregnant women, but you have a higher chance of (although small) of feeling pretty sick. 
  • Most women admitted into hospital, are given an oxygen mask session to saturate their blood better and only a very small percentage are in intensive care.
  • You're risk of preterm birth does increase mildly, but only by a small percentage based on yearly rates of premature birth before covid was present.
  • If you're baby does decide to join you early, most are being born in the mid third trimester which naturally limits the risk to your baby.
  • Your risk of preeclampsia increases just under 2%
  • Any perinatal death was only found in unvaccinated women and could not categorically be blamed on covid infection as the rate of stillbirth for the population didn't fluctuate in the main study. This means that perinatal death hasn't gone up or down during covid.
  • The evidence does seem to point that if you are vaccinated you're risk of these worries does seem to reduce.
So mama, how are you feeling? I know there is so much information circulating out there and I am honoured that you took the time to read and hopefully find comfort in some of these numbers. Of course things are ever changing and moving, but armed with this information you can debunk some of the myths coming your way, or at least know where to go when your doctor or midwife can’t give you the facts.

Unlock the power of informed decision-making with BirthTools™. Say goodbye to the overwhelming emotion and confusion that often comes with induction, going past your due date, and other pregnancy complications. Our comprehensive, easy-to-understand resources will provide you with the knowledge you need, without any of the fluff. Empower yourself today with the confidence that comes from having the right information at your fingertips!"

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References

Stock SJ, Carruthers J, Calvert C, et al. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland [published correction appears in Nat Med. 2022 Feb 4;:]. Nat Med. 2022;28(3):504-512. doi:10.1038/s41591-021-01666-2

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Vousden Nicola, Ramakrishnan Rema, Bunch Kathryn, et al. (2021). Impact of SARS-COV-2 variant on the severity of maternal infection and perinatal outcomes: Data from the UK Obstetric Surveillance System national cohort. medRxiv.

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Centre for Epidemiology and Evidence. New South Wales Mothers and Babies 2020. Sydney: NSW Ministry of Health, 2021.

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Conde-Agudelo Agustin, Romero Roberto (2021). SARS-CoV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2021 July 21.
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