Severe COVID risk for pregnant women is real, says large study from Kaiser in California

Unvaccinated pregnant women infected with the coronavirus are more than twice as likely to have dangerous sepsis or other serious medical problems as those who don’t have the virus, a study of thousands of women in northern California released Monday.

Analysis of 43,886 women who gave birth in Kaiser Permanente Northern California between March 1, 2020 and March 16, 2021 – before coronavirus vaccines became widely available – found that babies born to mothers who contracted the COVID were also more likely to be born prematurely, putting them at increased risk for brain and heart problems.

“These results add to growing evidence that having COVID-19 during pregnancy increases the risk of serious complications,” said Dr. Assiamira Ferrara, lead study author and Kaiser Permanente diabetes expert and obesity during pregnancy.

The study, published in the journal JAMA Internal Medicine, did not include vaccinated people, but supports evidence elsewhere that getting the coronavirus vaccine during pregnancy is key to avoiding serious medical problems, Ferrara said.

Despite ample evidence that it is safe to get vaccinated during pregnancy, many pregnant women are hesitant to get vaccinated. Less than a third of pregnant women had been vaccinated as of last fall, the Centers for Disease Control and Prevention reported.

Nationwide, 188,581 pregnant women have had COVID-19 since the pandemic began, which is a 10% increase from last month, according to the CDC. A total of 292 pregnant women have died from COVID, including at least 16 this year.

The Kaiser study looked at the medical outcomes of 43,886 pregnant women who had not been vaccinated. They included 1,332 who tested positive for coronavirus, and they were three times more likely to have a blood clot than uninfected women.

People infected with the virus were also 2.5 times more likely to suffer serious illness during pregnancy.

Of those who tested positive for the coronavirus, 76 women experienced a serious medical condition, or 5.7%.

Most often, the women suffered from acute respiratory distress syndrome or sepsis, a life-threatening condition affecting major organs.

Also, 143 of the women who tested positive gave birth to a premature baby, i.e. nearly 11%.

A total of 5.7% of people with COVID required hospitalization during pregnancy due to the virus. Those most likely to need hospitalization were black or Asian/Pacific Islander people, and women who had diabetes before becoming pregnant.

About two-thirds of study participants were non-white — including 28% Latina, 26% Asian or Pacific Islander, and 6.5% Black.

Dr. Stephanie Gaw, a maternal-fetal medicine expert at UCSF who was not affiliated with the study, praised it for “establishing evidence that COVID-19 in pregnancy is harmful to the mother and pregnancy” and for supporting the need for protective public health measures, from vaccines to masking in high-risk situations.

Because all participants were members of Kaiser, a managed care system, the results did not include the most vulnerable women without insurance, Gaw noted.

“We would expect the results to be even worse for these patients,” she said. Other downsides were that the study ended before the more severe delta variant of the virus emerged last summer, and no vaccinated women were included – although the vaccines became available on a limited basis three months before the end of the one-year study.

Meanwhile, the new study found no increase in stillbirths among infected mothers. A November study of 1.2 million women by the Centers for Disease Control and Prevention found an increased risk of stillbirth, but the rate was generally below 1%.

Nanette Asimov is an editor for the San Francisco Chronicle. Email: nasimov@sfchronicle.comTwitter: @NanetteAsimov

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