Scientists estimate perinatal mortality for pregnant women infected with coronavirus

(ORDO NEWS) — A study based on data from pregnant women in Scotland showed how many perinatal deaths are caused by Covid-19.

The rate of perinatal mortality (i.e. death of a fetus or newborn) for women who contracted the coronavirus while pregnant was 22.6 per 1,000 births, compared with 5.6 per 1,000, according to a nationwide Scottish study published today in the journal Nature Medicine.

Births among those who did not have Covid-19. The researchers also found that the severe consequences of the infection for expectant mothers, including hospitalization in intensive care, were more common among unvaccinated.

As the authors of the work note, it is pregnant women who, apparently, are not at a higher risk of infection with SARS-CoV-2, when compared with the rest of the so-called fair sex.

However, they are more likely to face the likelihood of a severe course of Covid-19: they end up in hospitals, need invasive mechanical ventilation, ECMO and, in the end. In addition, coronavirus infection leads to pregnancy complications such as preeclampsia, premature birth and stillbirth.

Scientists used a database of vaccinations and cases of Covid-19 among Scottish women who were expecting a baby during the current pandemic. The sample included 144,548 pregnancies in 130,875 women.

During the observation period, 117,190 pregnancies were resolved, of which 13,933 ended prematurely (due to miscarriage, implantation and development of the ovum outside the uterus or hydatidiform mole ), another 20,480 were interrupted, 79,148 ended in childbirth, and there is no information on 3629 It was. As a result of childbirth, 273 stillbirths and 179 infant deaths were recorded.

Among pregnant women, there were much fewer (32%) vaccinated against Covid-19 than among the female population aged 18-44 in general (77%). Moreover, according to the data received, for vaccinated women, mortality was similar to the background rates for residents of Scotland who did not have Covid-19.

From March 1, 2020 to the end of October 2021, 5653 cases of SARS-CoV-2 infection during pregnancy were recorded (with peak incidence, as for the entire population, in October 2020, January 2021 and September 2021) . Infection rates remained highest among parturient women living in the most disadvantaged areas and among younger pregnant women.

Since December 2020, 823 pregnant women with Covid-19 out of 4950 (16.6%) have required hospitalization, and 104 women (2.1%) have been referred to intensive care. More than 77% of infections occurred in expectant mothers who were not vaccinated at that time; 11.5% – for those vaccinated with one component, 11.1% – for fully vaccinated. Among those admitted to the hospital, 91% were unvaccinated, and among those admitted to intensive care, their proportion reached 98.1%.

To date, Scotland has recorded only one maternal death due to coronavirus infection before the birth of a child. From December 2020 to November 2021, 2,364 babies were born to women who had Covid-19 during pregnancy.

The rate of preterm birth within 28 days of infection was 16.6%, the scientists added. Of the total, 11 children died in the womb (before the 24th week of pregnancy), and eight died in the first four weeks after birth. Since ten more stillbirths and four neonatal deaths occurred when a woman gave birth within 28 days of being diagnosed with Covid-19, the expanded perinatal mortality rate for the unvaccinated was estimated at 22.6 per 1,000 births.

For comparison: the background rate of preterm birth during the pandemic is 8.0% (6381 out of 80,183 live births), and the extended perinatal mortality rate in this case is 5.6 per 1000 births (452 ​​out of 80,456 births).

The rate of preterm birth in women vaccinated against coronavirus during pregnancy was estimated at 8.6% (495 out of 5752 live births) and 8.2% (134 out of 1632 live births) within four weeks of vaccination. Their extended perinatal mortality was 4.3 per 1000 births.

The authors of the report were unable to find out whether the coronavirus disease directly or indirectly contributed to premature birth and death of the fetus (or child), since they did not have access to full medical records. However, the researchers concluded that pregnant women should be vaccinated against Covid-19 to avoid adverse outcomes for both themselves and the unborn child.

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