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CDC Data Highlights Likelihood of Severe COVID-19 During Pregnancy

Pregnant woman in shadow wearing a face mask and looking out a window.

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Key Takeaways

  • Although the overall risk to pregnant people remains small, new research from the Centers for Disease Control and Prevention (CDC) has shown that pregnant people with COVID-19 are more likely to be admitted to the ICU and need a ventilator.
  • Experts say that people who are pregnant might be at an increased risk for severe illness in part because of the changes in their immune system and respiratory system.
  • CDC researchers found that people who tested positive for COVID-19 during pregnancy were also more likely to deliver their babies early. 

The Centers for Disease Control and Prevention (CDC) has released a new study showing that people who are pregnant are at a higher risk for severe illness and death from COVID-19.

The data, which was published in the CDC’s Morbidity and Mortality Weekly Report on November 2, looked at approximately 23,434 pregnant people between the ages of 15 and 44 with symptomatic COVID-19.

Pregnant patients with COVID-19 were three times more likely than nonpregnant patients to be admitted to an intensive care unit (ICU), and almost three times more likely to receive invasive ventilation. The research also reported 34 deaths among the pregnant people who had symptoms, “reflecting a 70% increased risk for death,” compared to nonpregnant patients.

COVID-19 patients who were pregnant were three times more likely to be admitted to an intensive care unit (ICU) and almost three times more likely to be on a ventilator than patients who were not pregnant.

“This population-based study confirms what those of us who care for pregnant women with COVID have experienced…More than anything, it validates the experience of those of us on the front lines,” Ashley Roman, MD, OB/GYN, director of the Division of Maternal-Fetal Medicine at NYU Langone Health in New York City, tells Verywell.  

“I was not surprised by the study; the issue with COVID and pregnancy falls into two categories, one of them being that the physiology of women is somewhat different than the normal population," Manny Alvarez, MD, OB/GYN, Chairman of the Department of Obstetrics & Gynecology at the Hackensack-Meridian School of Medicine at Seton Hall University, tells Verywell. "And one of the biggest issues that increases the mortality of women who have COVID has to do with the pregnancy creating changes in the respiratory system, so they tend to decompensate (have trouble breathing) more quickly than nonpregnant patients."

Although the study analyzed patients within a wide age range, it’s important to note that pregnant people between the ages of 35 and 44 who contracted COVID-19 were about four times as likely to be put on a ventilator and twice as likely to die than nonpregnant patients in the same age bracket.

Racial Disparities

The increased risk for pregnant patients also highlighted the racial disparities of the pandemic. Only 14% of pregnant and nonpregnant participants in the study were Black women. Yet Black women represent 37% of overall deaths recorded and 26% of deaths among pregnant women. Similarly, pregnant Hispanic women had 2.4 times the risk of death.

“We continue to struggle with ethnic differences in access to healthcare, so even though this is a small sample of patients, it does tell you that women of color may still have limitations in accessing healthcare services," Alvarez says.

Why Pregnant People Are At Risk

Experts believe that the increased risk for pregnant patients with COVID-19 might come, in part, from physiological changes of pregnancy.

“Immune function declines with pregnancy to allow the fetus— which is really a foreign organism—to live and thrive in the mother's body. The body also has a diminished ability to fight off viral illnesses,” Kecia Gaither, MD, OB/GYN, MPH, director of perinatal services at NYC Health + Hospitals/Lincoln, tells Verywell. “The enlarging uterus pushes against the upper abdomen decreasing lung capacity. All of these factors converge to make pregnancy especially a precarious time during the pandemic.” 

Gaither adds that people with poorly controlled diabetes should be especially cautious, as research has shown that people with diabetes have an increased risk of worse outcomes if they get COVID-19.

The CDC says that “the absolute risks for severe COVID-19–associated outcomes among women were low,” but doctors are still urging patients to take extra safety measures.

“I have been advising patients on handwashing, social distancing, mask-wearing, boosting immunity with vitamin D, and increasing foods in their diets which boost immunity (onions, garlic, turmeric), limiting family and friends in the home unless they have had recent COVID-19 testing,” Gaither says.

The Risks for Infants

In a separate report, the CDC released data on the risk of preterm birth in pregnant patients with COVID-19. The researchers studied 3,912 live births from people diagnosed with COVID-19 and found 12.9% were preterm—2.7% higher than the reported amount of preterm births among the general population in 2019.

Babies born prematurely (before 37 weeks of pregnancy) have an increased risk of death and health conditions such as cerebral palsy, developmental delays, as well as hearing and vision problems.

The study also looked at the outcomes for infants of people who contracted COVID-19. Among the 610 babies tested, only 2.6% had positive results, and the infections “occurred primarily among infants whose mother had SARS-CoV-2 infection identified within 1 week of delivery.”

“I think we still do not have enough information on neonatal or fetal outcomes. Hopefully, current ongoing studies will help elucidate more information on this,” Joanne Stone, MD, MS, FACOG, director of Maternal-Fetal Medicine at Mount Sinai in New York City, tells Verywell. Stone, who was not involved in the latest CDC study, says that her hospital is currently evaluating the topic for a study sponsored by the CDC.

What This Means For You

If you’re pregnant or know someone who is, it’s more important than ever to keep up with COVID-19 safety guidelines and take precautions.

The new research from the CDC suggests pregnant people who contract the virus might be at higher risk for developing severe illness compared to people who are not pregnant.

The risk is still relatively small, but with COVID-19 cases rising across the country, the CDC advises pregnant patients to get a flu shot and continue to receive prenatal care.

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