Do pregnant women have higher health risks from Covid-19?

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• Covid-19. Pregnant women have a risk between 2 and 6 times greater of being admitted to the ICU

It is well known that pregnancy increases the chance of severe forms of respiratory viral infections such as seasonal influenza every year, and was seen with influenza A in 2009, or the epidemics of MERS of 2013 and SARS of 2003. In The latter was found to have a higher risk of being admitted to intensive care units and of dying if they suffered from the infection than pregnant non-pregnant women.

In addition,

than pregnant women without infection.

The current pandemic bears many similarities to past epidemics.

Although the evidence is still scarce, we are observing how pregnant women with Covid-19 have worse health outcomes than the general population.

For example, they have a 2 to 6 times greater risk of being admitted to intensive care units and up to 3 times more likely to need mechanical ventilation than infected non-pregnant women of the same age.

Even so, at the moment

.

Do we know what are the reasons that make pregnant women have a greater risk of suffering from severe forms of Covid-19?

They are multiple but some are not well known.

In the first place, the immune system of the pregnant woman is on the one hand

, but at the same time it is fully active and can cause the inflammatory complications described in this infection.

On the other hand, SARS-CoV-2

due to the less space available for the lungs as the uterus grows, and due to the increasing supply of oxygen that the fetus needs to develop.

As obstetricians often say "in pregnancy the heart works for two", and if you are also infected by a virus that affects the blood vessels and inflames them, this will further increase the work that the heart has to do.

Last but not least, coagulation changes occur in pregnancy with the aim of reducing bleeding at delivery and thus reducing the risk of life-threatening bleeding.

However, this change in pregnancy, which can be considered "defensive", in the case of infection by this virus can become a serious complication.

This is due to the fact that SARS-CoV-2 in turn increases the risk of clotting phenomena, which is leading to the observation of a

.

And what happens to the fetus and newborn if the mother is infected with SARS-CoV-2?

In this case, the information available in this regard is even scarcer.

Although it seems rare, it has been observed that the future newborn can become infected if the mother becomes infected in the final months of pregnancy, as in a recently published case.

On the other hand, it

still too

if the mother becomes infected early in pregnancy, when tissues and organs are formed.

But what does seem likely is that

and if the placenta has blood clots that decrease the delivery of oxygen to the growing baby.

In summary, many urgent questions remain unanswered and we have few answers to help understand the risks of SARS-CoV-2 infection in the mother and fetus and the effects of the drugs that are recommended to treat others. sick, among other issues.

At this point it is important to know that there is currently

with one of the drugs proposed to prevent Covid-19 infection, a study that is being carried out in Spain with public funding.

It is necessary to recognize that pregnant women are a risk group in this epidemic with which we will live for an indeterminate time so that, acting accordingly, we can urgently obtain reliable information on the possible complications of the disease during pregnancy.

At the same time, it

, which provide therapeutic and preventive solutions to reduce the risks of infection in pregnant women.

The scientific community owes them answers so that Covid-19 does not add uncertainty to a period as sensitive as pregnancy.

* Clara Menéndez, Clara Pons, Elena Marbán, Laura García, Raquel González and Azucena Bardají are researchers at the Barcelona Institute for Global Health (ISGlobal), a center promoted by the "la Caixa" Foundation, also attached to the Hospital Clínic and the University from Barcelona.

Anna Goncé, Maternal-Fetal Medicine service of the Clinical Institute of Gynecology and Obstetrics (ICGON) - Hospital Clínic de Barcelona - BCNatal.

María del Mar Gil, Obstetrics and Gynecology Service of the Torrejón University Hospital.

Mónica Cristina Cruz Lemini, Obstetrics and Gynecology Service of the Hospital de la Santa Creu i Sant Pau.

Elisa María Sáez Cerezal, Obstetrics and Gynecology Service of the Infanta Leonor University Hospital.

Elisa Llurba Olivé, Gynecology and Obstetrics service of the Hospital de la Santa Creu i Sant Pau.

Edurne Mazarico Gallego, Obstetrics and Gynecology service at the Sant Joan de Déu Hospital.

Elena Ferriols, Obstetrics and Gynecology Service of the Hospital del Mar. Paloma Toro, Obstetrics and Gynecology Service of the General Hospital of Segovia.

Mª Begoña Adiego Burgos, Gynecology and Obstetrics service of the Alcorcón Foundation University Hospital.

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• Science and Health

• Coronavirus

• Covid 19

• Infectious diseases

• Respiratory diseases

• Pregnancy

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