Pregnancy may make COVID-19 more severe,
CDC research team says
Last Updated 3 July, 2020. Cellspect Co., Ltd.
Pregnancy is a special time full of excitement and anticipation. But this year, for expectant mothers facing the outbreak of the coronavirus disease (COVID-19), fear, anxiety and uncertainty are clouding this otherwise happy time.
Before, the effects of COVID-19 on pregnant women and birth results were a mystery because there just weren't many large studies on the topic. The Centers for Disease Control and Prevention (CDC) had previously said there was "no data showing that COVID-19 affects pregnant people differently than others." However, as a recent study came out, the new findings have led the agency to update and include the pregnant people into the list of who is at increased risk for getting severely ill from COVID-19.
This new report includes the largest US cohort of pregnant women with lab-confirmed SARS-CoV-2 infection. Sascha Ellington, PhD, of the CDC's COVID-19 Response Pregnancy and Infant Linked Outcomes Team, and her team analyzed information from more than 8,200 pregnant women and 83,200 nonpregnant women in the U.S. ages 15 to 44 who tested positive for COVID-19 between January and June. They found that pregnant women were 5.4 times more likely to be hospitalized, 1.5 times more likely to be admitted to the ICU, and 1.7 times more likely to need mechanical ventilation. 
Notably, the study could not distinguish between pregnant women who were hospitalized for delivery or other pregnancy-related procedures, from those who were hospitalized for issues specifically related to COVID-19. (In addition, the authors also noted that doctors may have a lower threshold for hospitalizing pregnant patients.) In other words, being hospitalized in this case does not necessarily indicate severe COVID-19 illness.
The mechanism is not fully clarified. However, pregnancy causes changes to the immune and respiratory systems which has led to speculation that pregnant women might be more vulnerable to the disease and get increased risk for more severe illness from respiratory infections. [3-4]
"There's a good news bad news picture here," Dr. Dana Meaney-Delman, a COVID-19 deputy incident manager with the CDC, said at a news briefing on June 25. The good news is that pregnant women don't seem more likely to die of COVID-19, but the bad news is that they do have a higher risk of ICU admissions and need for mechanical ventilation, she said. The risk of death from COVID-19 was the same for pregnant and nonpregnant women — the fatality rate in both groups was 0.2%.
This study also showed racial disparities among the pregnant women with coronavirus infection: 46% were Hispanic, 22% were Black and 23% were White. The researchers noted that those proportions differ from pregnancy data from 2019, showing that among women who gave birth last year, 24% were Hispanic, 15% were Black and 51% were White. This suggests Black and Hispanic women are more likely to be hospitalized with coronavirus, something that has been seen in other research.
During the pandemic of COVID-19, the CDC recommends that pregnant women limit interactions with other people as much as possible, and when they do interact with others, to take precautions such as maintaining a 6-foot (1.8 meters) distance from others and wearing a face covering. Pregnant women should also attend prenatal care appointments and make sure they have at least a 30-day supply of any medicines they take. A figure is also provided by March of Dimes Fund to let pregnant women know how to protect themselves in this outbreak.
COVID-19: Things to know if you're pregnant (Copyright © 2020 March of Dimes. All rights reserved) 
1. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/
2. Sascha Ellington et al., June 26, 2020 “Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2
Infection by Pregnancy Status — United States, January 22–June 7, 2020”. Morbidity and Mortality Weekly Report (MMWR)
3. Ramsey PS et al., 2001 “Pneumonia in pregnancy.” Obstet Gynecol Clin North Am 28:553–69.
4. Rasmussen SA et al. 2011 “Pandemic Influenza and Pregnancy Working Group. Preparing for influenza after 2009 H1N1:
special considerations for pregnant women and newborns.” Am J Obstet Gynecol 204(Suppl 1):S13–20.
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