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NPR News on Novel Coronavirus

Pregnant people who contract COVID-19 are at a higher risk for death

ADRIAN FLORIDO, HOST:

New information is starting to come out about the effects of COVID-19 on pregnancy. And a study in the Journal of the American Medical Association found that pregnant mothers infected by the virus are at greater risk of developing serious complications or even dying during pregnancy. Dr. Torri Metz is an associate professor at the University of Utah Health and one of the study's authors, and she joins us now.

Welcome.

TORRI METZ: Thanks for having me. It's great to be here.

FLORIDO: Tell us more about what your report found.

METZ: What we did was evaluate if SARS-CoV-2 infection during pregnancy was associated with worse outcomes for moms. And more specifically, we looked at death or really serious morbidity from obstetric complications. The - such complications that we looked at were having high blood pressure in pregnancy, having a postpartum hemorrhage or bleeding after pregnancy or having an infection other than SARS-CoV-2, so for having wound infection or something that happened after your delivery. And what we found is that those women who had SARS-CoV-2 in pregnancy did have a higher risk of having this really serious morbidity or dying during the pregnancy. And when we say serious morbidity, it wasn't just having those conditions. But it was really having complications from those conditions.

FLORIDO: And how much higher of a risk do these pregnant women face?

METZ: Yeah. So we saw an overall 40% higher risk, but we can translate that into more absolute numbers. So the people who had SARS-CoV-2 in pregnancy had a 13% risk and those who didn't had a 9% risk.

FLORIDO: What is it about COVID that puts them at higher risk?

METZ: It's a good question, and we have a couple of hypotheses. And I think it's probably a combination of factors, honestly. The infection itself puts people at higher risk. We know that the SARS-CoV-2 virus does affect the placenta and can lead to some pregnancy complications, like high blood pressure. We also know that there are a lot of changes to health care delivery during the time of the pandemic. And these data were all collected in 2020, so early in the pandemic. And at that time, people were worried about going to the hospital. And so there may have been delays in care. And that way that resulted in higher risks of these serious morbidities. Or, you know, it could be that health care providers needed to put on special personal protective equipment to care for people who had COVID-19, and that could have led to some delays that resulted in serious morbidity. And honestly, it's probably a combination of a lot of those factors.

FLORIDO: And what about the risks to the newborns themselves?

METZ: Yeah. We also did see risks to the newborns themselves. They were at higher risk of being born preterm when the mother had SARS-CoV-2, and they were also at higher risk of needing to go to the ICU or the neonatal intensive care unit.

FLORIDO: And did it matter at all if the infection that the mother suffered was was mild or severe?

METZ: It did matter. And I think that that's a really important point. And that is one of the things that we looked at. You know, the numbers that we've been talking about are really overall. But when we looked at this more closely by COVID-19 severity, we found that, really, these risks were much higher in people who had moderate or higher COVID-19 severity. So people who had an oxygen requirement, people who were needing to be admitted to the hospital to be taken care of when they had COVID-19 are really the ones that are affected by these worse obstetric outcomes.

FLORIDO: Well, the CDC has strongly advised pregnant moms to get vaccinated. How does vaccination factor in here?

METZ: I think that this just gives us more information to talk to pregnant people, to tell them that, you know, vaccination is safe and effective. Not only is it going to keep them safe from having more severe or critical COVID or dying of COVID. But also, you know, based on these data, it should decrease their risk of having really significant obstetric complications, as well.

FLORIDO: Dr. Metz, what do you tell pregnant people about the best way to keep themselves and their pregnancy safe?

METZ: I really tell them that number one, vaccination is the best thing that they can do for both themselves and for the pregnancy and that it's safe at any time in pregnancy. Beyond that, I tell them to exercise caution just like we tell other people, you know, when you are going to be indoors, wearing masks, staying socially distant. You know, obviously, the CDC has changed their guidance in low-transmission areas, but I still tell my patients to exercise caution. We really don't want them to be contracting SARS-CoV-2 during pregnancy, given all these known increase risks.

FLORIDO: Dr. Torri Metz is an associate professor at the University of Utah Health. Thank you for being with us.

METZ: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.