Severe Covid 19 risks no greater for pregnant women

Unravelling the puzzle

https://images.unsplash.com/photo-1494059980473-813e73ee784b?ixlib=rb-1.2.1&q=80&fm=jpg&crop=entropy&cs=tinysrgb&dl=hans-peter-gauster-3y1zF4hIPCg-unsplash.jpg&w=2400There has been a lot of stress and anxiety surrounding the guidelines for pregnancy and birth during the coronavirus pandemic. Initially the guidelines were based around the theoretical possibility that pregnant women and people were in the ‘at risk’ or vulnerable category. The reason behind the caution is that in some pregnancies, because the immune system is altered, there is a more severe response to viral infections like flu. This does not appear to be the case with coronavirus.

A recent study (12/05/2020) "Pregnant women are not at greater risk of severe COVID-19 than other women" examined 427 covid positive women admitted to hospital between 1st March and 14th April found no evidence to suggest pregnant women are  at greater than average  risk of developing a severere reaction to the virus. 

BAME community at higher risk from C19

andre adjahoe unsplash https://images.unsplash.com/photo-1512094476718-4d8f19366c62?ixlib=rb-1.2.1&q=80&fm=jpg&crop=entropy&cs=tinysrgb&dl=andre-adjahoe-tqunk3qB_yU-unsplash.jpg&w=2400The same study concluded that people with a BAME ( black, asian and minority ethnic) background, and those with pre existing conditions, overweight or over 35 yrs old have an increased chance of becoming ill enough to require admission to hospital should they contract the virus. Those who experienced severe symptoms were in the third trimester of pregnancy emphasising the importance of social distancing during this time.

Professor Marian Knight, Professor of Maternal and Child Population Health at the Nuffield Department of Population Health, University of Oxford and lead investigator for the study, said, somewhat understatedly: 

"it is concerning that more pregnant women from black and minority ethnic groups are admitted with COVID-19 in pregnancy and this needs urgent investigation"

In my view worse than average outcomes for women from the BAME community with C19 could well reflect the general level of poorer outcomes for the same group. It's becoming clear that the distortion of health outcomes for ethnic minorities go far beyond Covid 19 and the maternity outcomes for the BAME community will be the subject of another blog.

REvised guidelines

The Royal College of Obstetricians & Gynaecologists updated guidelines 12/06/20 reflect the clearer picture this research delivers and the decreasing number of infections since lockdown.

The update includes changes to hospital visiting policies announced on 5/06/20, including:

  • mask wearing,
  • having a baby when you have the virus,
  • occupational health guidance if you work with the public,
  • your partner may now accompany you to scans and appointments in the hospital. 

Not all hospitals have implemented the new guidance so please check with your local hospital trust first. If they haven’t changed or are not changing the policy get in touch with your local Maternity Voices Partnership (MVP) It’s important to understand the reasons why the guidance has not been implemented and that your voice is heard.

posted 19-06-2020

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