Higher risk of pregnancy complications in unvaccinated women

This study analyzed the Covid-19 vaccine uptake and SARS-CoV-2 infection in all women who were pregnant on or after March 1, 2020. Between December 8, 2020, and October 31, 2021, 25,917 COVID-19 vaccinations were given to 18,457 pregnant women. But compared to the general female population, the rate of complete vaccination (two doses) in the pregnant women was significantly lower; 77.4% vs 32.3%, respectively.

For the purpose of the study, the pregnant women were categorized into three groups: unvaccinated (no previous COVID-19 vaccination before the date of onset of COVID-19 or with one dose of vaccination ≤21 d before the date of onset), partially vaccinated (one dose of vaccination >21 d before the date of onset of COVID-19 or two doses of vaccination with the second dose administered ≤14 d before the date of onset) or fully vaccinated (two doses of vaccination with the second dose >14 d before the date of onset of Covid-19).

The extended perinatal mortality rate for women who delivered within 28 days of their Covid diagnosis was 22.6 per 1,000 births compared with 5.6 per 1,000 births for all babies delivered between March 1 and October 31, 2020.

Overall, 77.4% of SARS-CoV-2 infections, ~91% of SARS-CoV-2-related hospitalizations and 98% of SARS-CoV-2-related critical-care admission along with all baby deaths occurred in the unvaccinated pregnant women.

The likelihood of pregnant women developing Covid-19 is comparable to non-pregnant women. However, pregnant women are at higher risk of developing severe disease with greater probability of ICU admissions, need for mechanical ventilation and mortality. The chances of pregnancy-related complications such as pre-eclampsia, preterm birth and stillbirth increase in pregnant women with Covid-19.

This study has shown that the vaccination during pregnancy was low in Scotland during the predominant delta wave. Consequently, the hospitalizations, including critical care admissions, due to Covid-19 and perinatal mortality, occurred more frequently in those pregnant women who were not vaccinated.

Covid-19 vaccines are safe and effective in protecting against severe disease. As per a CDC advisory, the benefits of vaccination for both pregnant women and their child outweigh the risks, whether known or potential. The CDC also recommends COVID-19 vaccine booster dose at the scheduled time. India also recommends Covid-19 vaccine for pregnant women, though they are not yet approved for precaution dose yet

Therefore, all clinicians involved in the care of pregnant women must educate them about the importance of taking Covid-19 vaccine and that they are safe and effective. They must be encouraged to take the vaccine at the earliest to protect their health as well as that of their baby.