A year on, startling new findings about Covid and pregnant women revealed

These results confirmed the team’s initial fears. “The outbreaks of Sars and Mers had very bad effects during pregnancy and were also coronaviruses,” says Papageorghiou. “Our immediate concern was would Covid be that bad?”

Their efforts to find this out began just as the pandemic hit the world, when they began collecting data on pregnant women infected with Covid around the world. Rather than comparing their fate to that of non-pregnant women, as other, smaller studies have done, the team compared them to non-infected pregnant women in the same hospitals at the same time, allowing them to compare like with like. The result is the largest and most robust international study of the effects of Covid on pregnancy.

what the numbers say

The study was reassuring in that it found that pregnant women with Covid who had no symptoms were at no greater risk than those without the virus. But for those with symptoms, the consequences could be dramatic. They were 46 percent more likely to have high blood pressure; 76 percent more likely to develop preeclampsia; 70 percent more likely to endure fetal distress; 59 percent more likely to have a preterm birth; babies are 58 percent more likely to have low birth weight. “And we know that being born prematurely has long-term consequences,” says Kennedy.

Three times as many infected mothers developed infections that required antibiotics; five times as many ended up in intensive care. Of the 12 mothers who died, 11 were infected.

Women faced two main problems after contracting Covid. “There were the direct risks of the virus itself — the need to go to the intensive care unit and get respiratory support,” Papageorghiou says, “and then there were the implications of medical interventions that were required because of the illness.” As also expectant mothers, whose bodies are already under stress, have struggled to cope with Covid, doctors have often been forced to deliver babies early to save them.

“The effects tend to occur in the second half of pregnancy, when there is more weight to carry, strain on the diaphragm and breathing can be more difficult,” says Papageorghiou. “One way to improve this is to make the baby available to optimize the mother’s health.

“The breathing aspect is important,” he adds. “But the coronavirus causes abnormalities in several systems, affecting circulation and blood pressure and upsetting the normal balance. Not getting the virus is absolutely key.”

“Our goal,” Kennedy adds, “is not to scare women. Our goal is to inform. There are only three options for pregnant women: Self-isolation, which is bloody miserable and almost impossible for most pregnant women, especially those with other children. got the vaccine Or accept the risk of contracting Covid. That’s it. Since the medical profession does not fulfill its responsibility for good advice, our paper is intended to support families in making decisions. We know [now] that it is harmful to get Covid in pregnancy. All pregnant women should be vaccinated.”

What the study means for official advice

Back on the wards in December, that wasn’t the message Blaney was getting from the government. The Joint Committee on Vaccination and Immunization (JCVI) only recommended that vaccines should be “considered” if pregnant women are at high risk of complications or if they “cannot avoid” exposure to the virus.

Blaney considered official advice vague and unhelpful.[at a time] if you are unsure anyway. You do not see [outside hospital] how sick people can get from Covid.” Although she knew she was exposed, “I still needed to be persuaded that I should be vaccinated.”

When the results of her study became known, her father and Papageorghiou both tried desperately to convince her. Despite—or perhaps because of—her efforts, Blaney continued to vacillate, caught between maternal care and medical necessity—procrastination and vaccination. “I knew what the right thing was, but hesitation creeps in,” she says.

Her uncertainty was compounded by the fact that pregnant women were routinely excluded from vaccine safety studies, leaving her with no confirmation that vaccines were particularly safe for expectant mothers and their fetuses. “It definitely bothered me,” she says.

Understandably, this lack of data has also weighed on the JCVI in recent months. Last week she finally updated her recommendation – but only to suggest pregnant women get vaccinated when their age ranges are “eligible”, rather than as a matter of course.

The new advice remains inadequate, the study team says. “They say that pregnant women are at the same risk as everyone else, which is not true,” says Papageorghiou. “Pregnant women with Covid are at higher risk of serious complications than non-pregnant women of the same age with Covid.”

The good news about vaccines

Despite the absence of pregnant women in studies, the INTERCOVID team says women can have peace of mind today about the safety of the Pfizer and Moderna vaccines, which U.S. regulators have approved for pregnant women. As a result, 78,000 pregnant women in the US were vaccinated, with rates of complications and miscarriage no higher than normal. Today, UK regulators say pregnant women should only receive these vaccines and not AstraZeneca’s. “Given the known effects of Covid and no evidence of harm from a vaccine, I would advise my pregnant wife or daughter to get vaccinated,” says Papageorghiou.

Blaney finally decided to do it in early February: “It wasn’t until a counselor told me she would get the shot if she was pregnant that I went ahead,” she recalls.

Today, despite looking forward to the birth of her baby in May and having had no side effects from her second vaccination (she felt groggy for a few days after the first), she is still struggling to convince her pregnant friends. “They are very insecure.” A midwife and a nurse she knows both waited until after the birth and then got vaccinated “right after”.

“They weren’t fully aware of the risks [to pregnant women] catching Covid,” she says. However, thanks to the work of Blaney’s father and his colleagues, there is no longer any doubt.

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