Pregnancy and Covid-19: what is the risk for the mother? And for the fetus? What about the antibodies?

Pregnant women who contract COVID-19 have a higher risk of dying and experiencing serious complications compared to non-pregnant women who contract the disease, according to a recent report from the Centers for Disease Control and Prevention (CDC) from U.S.

The new study, presented on Thursday, January 28 at the annual meeting of the Society for Maternal-Fetal Medicine (SMFM) of the United States, ‘The Pregnancy Meeting’, researchers reveal findings that suggest that Pregnant women who become seriously or critically ill due to COVID-19 are at a higher risk of dying and experiencing serious pregnancy complications compared to pregnant women who have COVID-19 but were asymptomatic or without symptoms.

Conversely, pregnant women with mild or moderate disease did not have a higher risk of pregnancy complications than those without symptoms. The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The study examined the medical records of 1,219 pregnant women from 33 hospitals in 14 states from March 1, 2020 to July 31, 2020. All patients tested positive for COVID-19. Forty seven percent were asymptomatic, 27 percent were mild, 14 percent were moderate, 8 percent were severe, and 4 percent were critical.

The findings showed that pregnant women who became seriously or critically ill due to COVID-19 were older, had a higher body mass index, and were more likely to have underlying medical conditions, such as asthma / chronic obstructive pulmonary disease (COPD), diabetes , and high blood pressure.

These women were more likely to die or have serious complications, such as cesarean delivery; heavy bleeding after delivery, known as postpartum hemorrhage; high blood pressure during pregnancy; and premature labor. High blood pressure and preterm labor can also cause long-term health problems in women or their babies.

A total of four women (0.3%) died from COVID-19, a figure higher than the death rate for pregnant women without COVID-19. The death rate for pregnant women without COVID-19 is 17.4 deaths per 100,000 live births, according to the latest CDC data.

“Our research shows that serious pregnancy complications appear to occur in women who have severe or critical COVID cases and not in those who have mild or moderate cases,” notes the study’s lead author., Torri D. Metz, subspecialist in fetal medicine and associate professor at the University of Utah Health.

“This information helps us to advise our patients more effectively,” he explains. For pregnant women who have contracted a mild or moderate case of COVID-19, these findings may help alleviate their fears that they are at increased risk for serious pregnancy complications from the disease. “

WHAT HAPPENS TO ANTIBODIES IN PREGNANT WOMEN?

Another study to be presented that Thursday at the annual meeting of the Society for Maternal-Fetal Medicine (SMFM) of the United States, ‘The Pregnancy Meeting’, the researchers reveal findings that suggest that women who contract COVID-19 during pregnancy may produce antibodies, but the transfer of these antibodies to their babies is less than expected.

Antibodies are produced by the body’s immune system to help fight infection. Specifically, the study looked at immunoglobulin G (IgG) and neutralizing activity, a measure of the strength of the antibody response, in the maternal immune system.

IgG antibodies make up about 75 to 80 percent of all antibodies in the body and can cross the placenta to the fetus. Neutralizing antibodies block infection and make viruses less active.

“A recent study looked at the maternal antibody response to infection, but our study is the first to look at the maternal immune response and neutralizing antibodies,” explains one of the study’s lead authors, Naima Joseph, a maternal-fetal clinical researcher. Medicine at Emory University School of Medicine and a member of the SMFM COVID-19 Task Force. We also analyze the transfer of these antibodies through the placenta to the fetus ”.

The study analyzed maternal and umbilical cord blood samples from 32 women who tested positive for COVID-19 during pregnancy. Of the maternal samples collected, 100 percent contained IgG and 94 percent contained neutralizing antibodies. Of the cord blood samples, 91 percent contained IgG and 25 percent contained neutralizing antibodies.

“What’s interesting about this study is that even if a woman was asymptomatic, she still developed high levels of COVID-19 IgG and neutralizing antibodies,” explains Joseph.

“One of the main ways that babies are protected from infection is from the antibodies they receive in utero, so regardless of whether a woman was asymptomatic or not, we would have expected to see a higher percentage of antibodies transferred from mother to baby, especially neutralizing antibodies, ”acknowledges another of the study’s lead authors, Martina L. Badell, maternal-fetal subspecialist and associate professor at the Emory University School of Medicine.

“The next step is to understand why the transfer of antibodies is different in COVID-19 infection from other infections and if the transfer of these antibodies increases when we vaccinate a pregnant woman,” he advances.

With information from Europa Press

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