Pregnancy-related COVID-19 infection is associated with a higher risk of negative consequences.

 

Pregnancy-related COVID-19 infection is associated with a higher risk of negative consequences.

A research article from the American College of Cardiology Cardiovascular Disease in Women Committee found that COVID-19 infection in pregnant women is linked to a higher risk of unfavourable outcomes than in women who are not pregnant. The cardiovascular care team must be attentive when monitoring pregnant women with COVID-19 because to the cardiovascular consequences, which include heart attack, arrhythmias, heart failure, and long-term symptoms that can be difficult to distinguish from other cardiac issues of pregnancy.

In particular, in some high-risk populations, awareness of cardiovascular consequences grew as COVID-19 incidence increased globally. Up to 12% of patients are thought to experience heart attacks. The Centers for Disease Control and Prevention (CDC) discovered that pregnant women have a higher risk of negative outcomes with COVID-19 than non-pregnant women of reproductive age, including severe infection (10%), ICU admission (4%), mechanical ventilation (3%) and use of ECMO hemodynamic support (0.2%). The risk of serious infection was further elevated in pregnant patients with advanced maternal age, high body mass index, or other pre-existing diseases including chronic hypertension, pre-eclampsia, or pre-existing diabetes.

Pregnant COVID-19 patients had a greater risk of stillbirth and preterm birth than pregnant women without the virus. In total, 33% of babies born to COVID-19 patients were placed in the neonatal intensive care unit. There are no more discrepancies in the perinatal outcomes.

Significant racial discrepancies in COVID-19 patient outcomes for pregnant women were discovered in a study that was focused on the US. Non-Hispanic Black women made up 14.1% of the research group, yet they were responsible for 26.5% of all deaths related to pregnancy. In Hispanic women with COVID-19, pregnancy was linked to a 2.4-fold increased risk of death, while pregnant Asian and Native Hawaiian/Pacific Islanders had some of the highest rates of ICU hospitalizations.

The authors claim that the low vaccination rate among pregnant women in comparison to other groups is one factor contributing to the higher risk of cardiovascular problems. In a recent study of more than 130,000 pregnant people, more than 75 percent of those who needed hospital admission required critical care, and all fetal deaths happened in unvaccinated women as opposed to those who had received vaccinations.

The risks of a severe COVID-19 infection, including ICU hospitalizations, cardiac problems, the requirement for critical care, and patient or fetus mortality, are increased in pregnant women. Unfortunately, pregnant women have not gotten their vaccinations as quickly as other populations. The information at hand supports pregnant vaccination with a favourable safety profile and protective transmission to newborns. Pregnancy vaccination is advised by the CDC, American College of Obstetrics and Gynecology, Society of Maternal-Fetal Medicine, and others. I think our patients should support this recommendation.

Given the overlap of COVID-19 symptoms, cardiovascular illness, and pregnancy, the care of cardiac problems and diagnosis in pregnant COVID-19 patients might be complex. The timing of presentation and imaging findings, according to the authors, may aid in differentiating and establishing a diagnosis. During pregnancy and lactation, medical therapy may also need to be modified by clinicians.

According to the authors, managing cardiac complications in COVID-19 pregnant patients necessitates assembling a "Pregnancy Heart Team" to provide the best possible care. Depending on the type of complication, stage of pregnancy, and level of infection, this team may include medical professionals experienced in high-risk pregnancies, obstetric anesthesia, cardiology, critical care, and neonatal care.

Despite calls to include pregnant people, Briller claimed that the inability to include pregnant women in clinical studies hinders the recognition of cardiovascular complications. Because there isn’t enough research on the safety and effectiveness of treatments during pregnancy, women "may be undertreated or insufficiently treated or, conversely, exposed to treatments whose safety is unknown.