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Given recent WHO interim vaccine recs in pregnancy, I want to share our new work @AJOG_thegray. Pregnant people are *TWICE* as likely to develop severe disease & have a 60% higher risk of death when it comes to #COVID19 as compared to non-pregnant women. https://www.ajog.org/article/S0002-9378(20)32573-4/fulltext
This is the largest & longest running effort yet to characterize COVID risk in pregnancy based on epidemiologic surveillance system of viral respiratory diseases of Mexico (475 monitoring hospitals in the Mexican Public Health Network). (Thanks to @Raigam_Martinez & colleagues).
The adjusted case fatality rate for pregnant women was 1.3% overall, but rose to 2.1% and 5.9% for those aged 35 to 39 years and 40 to 44 years, respectively.
Pregnant women w COVID consistently had a higher risk of death than nonpregnant women of similar age with COVID-19 (adjusted RR, 1.68; 95% CI, 1.36–2.08). The risk of death was elevated for both younger and older pregnant women.
Overall 8.7% of COVID-confirmed pregnant women had pneumonia, ranging from 7% in the youngest to 18% in the oldest group. Only a about 5% of non-pregnant women ended up with pneumonia.
Pregnant women have twice the risk of severe disease [aRR (95% CI): 1.97 (1.82 , 2.13)].
![Overall 8.7% of COVID-confirmed pregnant women had pneumonia, ranging from 7% in the youngest to 18% in the oldest group. Only a about 5% of non-pregnant women ended up with pneumonia. Pregnant women have twice the risk of severe disease [aRR (95% CI): 1.97 (1.82 , 2.13)].](https://pbs.twimg.com/media/Es1d1X9W4AAjJAU.png "Overall 8.7% of COVID-confirmed pregnant women had pneumonia, ranging from 7% in the youngest to 18% in the oldest group. Only a about 5% of non-pregnant women ended up with pneumonia. Pregnant women have twice the risk of severe disease [aRR (95% CI): 1.97 (1.82 , 2.13)].")
Pregnant women have twice the risk of severe disease [aRR (95% CI): 1.97 (1.82 , 2.13)].
Although the absolute risk of pneumonia was highest among older pregnant women, the highest *increased risk* (RRs) relative to non-pregnant people appeared among both younger and older pregnant women.
It's been repeatedly suggested to me that "pregnant women are young" and thus "age isn't a factor". But both young and old age confer risks in pregnancy. And our work suggests that the combination of COVID + pregnancy increases risks for both younger and older women.
The @WHO interim guidance re Moderna vaccine in pregnancy notes "COVID-19 has been associated with an increased risk of preterm birth".
Unfortunately the guidance disregards direct health risks to the mother herself. https://www.who.int/publications/i/item/interim-recommendations-for-use-of-the-moderna-mrna-1273-vaccine-against-covid-19
Unfortunately the guidance disregards direct health risks to the mother herself. https://www.who.int/publications/i/item/interim-recommendations-for-use-of-the-moderna-mrna-1273-vaccine-against-covid-19
