Covid-19 makes births more complicated

New studies have found that pregnant women who test positive for Covid-19 are more at risk of experiencing complications postpartum.
New studies have found that pregnant women who test positive for Covid-19 are more at risk of experiencing complications postpartum.
Image: 123RF/Andor Bujdoso

Pregnant women who contract Covid-19 are more likely to experience complications after birth compared to those who test negative, a new study has revealed.

According to new research carried out by researchers at Weill Cornell Medicine in New York City, US, women with Covid-19 are prone to developing oxygen deficiency (hypoxia) and fever, and are likely to be readmitted post-partum.  

The rate of C-sections was also high among women who presented to the labour ward with symptoms of Covid-19, with almost half (46.7%) who tested positive and showing symptoms delivering via C-section compared to 45.5% who tested positive, but were asymptomatic. Only 30.9% of women who did not have Covid-19 had caesarean deliveries.

The study, presented by lead researcher Malavika Prabhu at the 51st Union World Conference on Lung Health held virtually this week, y, revealed complications were encountered in about 13% of pregnant women who had Covid-19 in New York City compared to only 4.5% without Covid-19.

Meanwhile, a new South African study presented by the Medical Research Council (MRC) has shown that taking tuberculosis prophylaxis and isoniazid preventive therapy (IPT) during pregnancy not only prevented TB, but also saved lives of unborn babies as it was associated with a significantly higher live birth rate.

HIV-positive women who took prophylaxis were less likely to have miscarriages and still births, showing for the first time that the preventative therapy can be safely used during the second and third trimester of pregnancy.

TB is associated with increased risk of death and morbidity among pregnant women, particularly those living with HIV. Both pregnancy and HIV increase the risk of contracting TB.

Presenting the study at the conference, lead researcher Sikhethiwe Masuku said of the more than 800 HIV-positive women who received the therapy, about 95% had live births compared to 92.6% of those who were not exposed to therapy. However, more research is needed to determine the safety of TB prophylaxis during all three trimesters.

New York, which is one of the worst affected states in the US with about 261,000 Covid-19 cases and almost 24 000 deaths, has been universally screening pregnant women for Covid-19 and following them up post birth.

During the presentation of her research, Prabhu also noted that intraplacental thrombi (small collections of clotted blood) among pregnant women may have maternal and foetal implications for people with Covid-19.

“Overall, during the delivery, maternal and perinatal outcomes seemed reassuring, with no evidence of vertical transmission and no differences in the prematurity rate, although we did note some increases in caesarean delivery rates among women [with Covid-19],” she told conference delegates.

About nine out of the 70 women with Covid-19 experienced at least one postpartum complication. Prabhu said the huge disparities in complications between those with Covid-19 and those who tested negative suggested “the postpartum period specifically is a vulnerable time for pregnant women with Covid-19”.

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