Increased maternal mortality in unvaccinated SARS-CoV-2 infected pregnant patients

Atak, Zeliha; OCAKOGLU, Sakine RAHIMLI; Topal, Serra; Macunluoğlu, Aslı Ceren

doi:10.1080/01443615.2022.2099255

Cited by 9 publications

(11 citation statements)

References 28 publications

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“…These may partly explain the milder infection of Omicron in pregnant women. In addition, more severe maternal and perinatal outcomes were observed in pregnant women who were not vaccinated [ 10 , 19 , 32 , 43 ]. The result of a prospective study showed that, even though none of the infants born to pregnant women infected with SARS-CoV-2 developed a serious illness, 18 out of 20 of the infants with non-severe illness came from cases who were eligible for vaccination but did not receive it [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Deng

Liu

et al. 2022

IJERPH

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The aim of this study is to review the currently available data, and to explore the association of infection with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants during pregnancy with maternal and perinatal outcomes in the real world. Observational cohort studies were analyzed that described the maternal and perinatal outcomes of infection with different SARS-CoV-2 variants during pregnancy. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) for maternal and perinatal outcomes. Random effects were used to estimate the pooled odds ratios (OR) and their 95% CI for different outcomes between Delta and pre-Delta periods, and between Omicron and Delta periods. Eighteen studies, involving a total of 133,058 cases of SARS-CoV-2 infection during pregnancy (99,567 cases of SARS-CoV-2 wild type or pre-variant infection and 33,494 cases of SARS-CoV-2 variant infections), were included in this meta-analysis. Among pregnant women with SARS-CoV-2 infections, the PPs for required respiratory support, severe or critical illness, intensive care unit (ICU) admission, maternal death, and preterm birth <37 weeks were, respectively, 27.24% (95%CI, 20.51–33.97%), 24.96% (95%CI, 15.96–33.96%), 11.31% (95%CI, 4.00–18.61%), 4.20% (95%CI, 1.43–6.97%), and 33.85% (95%CI, 21.54–46.17%) in the Delta period, which were higher than those in the pre-Delta period, while the corresponding PPs were, respectively, 10.74% (95%CI, 6.05–15.46%), 11.99% (95%CI, 6.23–17.74%), 4.17% (95%CI, 1.53–6.80%), 0.63% (95%CI, 0.05–1.20%), and 18.58% (95%CI, 9.52–27.65%). The PPs for required respiratory support, severe or critical illness, and ICU admission were, respectively, 2.63% (95%CI, 0.98–4.28%), 1.11% (95%CI, 0.29–1.94%), and 1.83% (95%CI, 0.85–2.81%) in the Omicron period, which were lower than those in the pre-Delta and Delta periods. These results suggest that Omicron infections are associated with less severe maternal and neonatal adverse outcomes, though maternal ICU admission, the need for respiratory support, and preterm birth did also occur with Omicron infections. Since Omicron is currently the predominant strain globally, and has the highest rates of transmission, it is still important to remain vigilant in protecting the vulnerable populations of mothers and infants. In particular, obstetricians and gynecologists should not ignore the adverse risks of maternal ICU admission, respiratory support, and preterm births in pregnant patients with SARS-CoV-2 infections, in order to protect the health of mothers and infants.

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Section: Discussionmentioning

confidence: 99%

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Deng

Liu

et al. 2022

IJERPH

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“…In a recent retrospective study, the authors concluded that high ferritin, and C-reactive protein serum values were associated with poor prognosis and mortality in unvaccinated pregnant women with SARS-CoV-2 infection [ 23 ]. Moreover, a cross-sectional study that evaluated the clinical course of maternal mortality cases due to severe forms of COVID-19 indicated a higher frequency of leukocytosis with raised neutrophils: lymphocytes ratio, thrombocytopenia and elevated levels of acute phase reactants and inflammatory markers such as CRP, serum ferritin, lactate dehydrogenase (LDH), D-dimer, and serum fibrinogen in their cohort of unvaccinated patients [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Severe Disease and Intensive Care Unit Admission of Pregnant Patients with COVID-19 Infection—A Retrospective Study

Adam

Vasilache

Socolov

et al. 2022

JCM

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(1) Background: Pregnant patients with severe forms of coronavirus disease 2019 (COVID-19) can experience adverse pregnancy outcomes. The aim of this study was to retrospectively assess the risk factors associated with admission to the intensive care unit (ICU) of pregnant patients with COVID-19, as well as the pregnancy outcomes of these patients; (2) Methods: Medical records of 31 pregnant patients with COVID-19 admitted to three clinical hospitals from Romania, between October 2020 and November 2021 were examined. The patients were segregated into two groups depending on their clinical evolution: non-ICU admission (n = 19) or ICU admission (n = 12). Clinical and paraclinical findings were evaluated using univariate analysis, and the association of significant risk factors with maternal ICU admission was assessed using a multivariate analysis. Pregnancy outcomes of these patients were also recorded; (3) Results: Pulmonary disease, cough, dyspnea, leukocytosis, thrombocytosis, high serum values of transaminases, serum ferritin, and increased duration of hospital admission were identified as significant risk factors associated with maternal admission to the ICU. No significant differences regarding pregnancy outcomes were noted between the evaluated patients; (4) Conclusions: Specific risk factor identification in pregnant patients with severe forms of COVID-19 could improve the patient’s management.

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“…Chervenak et al stated that “…the longer physician hesitancy continues and the longer the low vaccine acceptance rate of pregnant women lasts, preventable serious diseases, deaths of pregnant women, intensive care unit admissions, stillbirths, and other maternal and fetal complications of unvaccinated women will continue to occur.” (Chervenak et al 2022 ) Unfortunately, their fears became a reality when, likely as a result of physician hesitancy and delaying vaccine recommendations for pregnant women by major organizations until later in 2021, unvaccinated women died at the end of 2021 and beginning of 2022 as a consequence of a lower vaccine acceptance rate by pregnant women. (Atak et al 2022 , Aslam et al 2022 ).…”

Section: Hesitation To Recommend Covid ‐19 Vaccina...mentioning

confidence: 98%

Physician hesitancy to recommend COVID‐19 vaccination in pregnancy as a cause of maternal deaths ‐ Robert Brent was prescient

Grünebaum

Chervenak

2022

Birth Defects Research

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Increased maternal mortality in unvaccinated SARS-CoV-2 infected pregnant patients

Cited by 9 publications

References 28 publications

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Association of Infection with Different SARS-CoV-2 Variants during Pregnancy with Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis

Risk Factors Associated with Severe Disease and Intensive Care Unit Admission of Pregnant Patients with COVID-19 Infection—A Retrospective Study

Physician hesitancy to recommend COVID‐19 vaccination in pregnancy as a cause of maternal deaths ‐ Robert Brent was prescient

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