- Hey, y'all. Welcome back.
I'm Mama Doctor Jones,
a board certified OB GYN and mom to four.
And today, I'm giving you an update
on COVID-19 in pregnancy.
This video has up-to-date information
to the best of my ability as of the day of filming,
which is August 31st, 2021.
In this video we're going to cover:
Are pregnant people more likely to contract COVID-19?
Are they more likely to have pregnancy complications
if they do?
Are they more likely to get very sick with COVID-19?
How does the Delta variant work into this conversation?
How is the fetus affected?
Can it cause congenital anomalies?
Will your baby be sick at the time of delivery
if you have COVID-19?
And do we even have any treatments
for COVID-19 during pregnancy?
Importantly, science changes.
Some of the things I say in this video will be different
than what I've said in other videos,
and some of the things I say in future videos
will also be different than this one.
We have to make sure we're following the data
that we have right now,
and being open to changing our mind
when we get new information.
(gentle music)
Are people who are pregnant more likely
to contract COVID-19?
The simple answer to this is no.
You are not more likely to get COVID-19
just because you are pregnant.
Meaning, if I'm pregnant and you're not;
I'm not, but for the purposes of this demonstration
let's pretend;
and we're standing in the same room
with somebody who happens to be COVID-19 positive.
I, as a pregnant person in this scenario,
am not more likely to get sick with COVID-19 than you,
the non-pregnant person.
However, I am more likely to get more sick
if we both get COVID than you are
as someone who is not pregnant.
That brings us to our next question which is,
does COVID-19 if contracted during pregnancy
increase the risk of pregnancy complications?
The answer to this one is yes.
There are several pregnancy complications that are increased
in people who are pregnant and have COVID-19
as compared to people who are pregnant
and don't have COVID-19.
Those increased risks include preterm delivery,
requiring oxygenation, needing to be admitted to the ICU,
needing to be intubated,
and unfortunately, you are also more likely to die.
You may notice if you've watched my previous videos
that I didn't include an increased risk of C-section
in that rundown.
Why? In previous videos, I had said,
"You're probably at an increased risk of C-section."
The data now that we've moved further into the pandemic
and we have more numbers
is seeming a little more mixed on this topic.
This can be due to several reasons.
One of them being an improved understanding of the virus
and how to provide supportive care
to people who are pregnant.
Another being that that original association
could have been due to chance,
and now that we have more numbers to look at,
we can see that more clearly.
It could be that that risk is more serious
in people with severe illness
and that now in our datasets,
we're including people who have asymptomatic
and mild disease because we're testing more frequently
or it could be and likely is a combination
of all of these things.
At the end of the day,
I think that it is very likely,
people who have COVID-19 in pregnancy and get severely ill
are going to be found to be at an increased risk
of cesarean delivery.
And this is because of what I talked about
in an earlier video,
which is that when somebody is decompensating or very sick,
a lot of times there is need to deliver the baby
to help make sure that that patient can start to get better.
So, I believe that we will probably find an association
with severe disease and need for a cesarean delivery,
but we'll have to wait and see.
Because right now, like I said, some of the data says yes
and some of it says no.
Let's move on to our next question which is,
how does the original data compare to variant data
about pregnancy and COVID-19 complication?
The data we currently have available does indicate
that the variants like the Delta variant
are causing more severe disease,
as well as worse maternal and neonatal complications
than the original wild type virus.
I will include some links in the resource box below.
But overall, we are seeing that it seems like people
are getting more sick
than they were with the original COVID strain.
Does COVID-19 lead to fetal malformations
or congenital anomalies?
This is actually good news.
There is no evidence right now to support any idea
that COVID-19 at any point in pregnancy
would increase the risk of fetal malformations
or congenital defects.
Does COVID-19 cause miscarriage?
Data on this has also been relatively sparse,
especially as it relates to COVID infections
specifically in the first and early second trimester
and also conflicting.
There has been some data has said,
maybe there's an increased risk of miscarriage,
but overall it's very conflicting.
Unfortunately, I'm going to have to continue
to answer this one with a non-answer.
We don't know for sure.
Hopefully soon, we will have information specific to people
who had COVID-19 early in the first and second trimester
so that we can lay out this information,
but because we only have wide data sets right now,
it's a little bit hard to tease out the actual associations
and the timeline with which those people
were infected during pregnancy.
Does COVID-19 increase the risk of stillbirth?
Data on this remains mixed as well.
Fortunately, stillbirth is incredibly rare at baseline.
Unfortunately, this means it's very hard to study.
Even if we see small increases,
even if we see percentage increases that look big
but are actually absolutely small on a large scale,
it is hard to tease out if that is related to chance
or something going on in the environment.
Right now, we don't have any really good data
that indicates having COVID-19 while you are pregnant
would increase the risk of stillbirth.
However, based on the data we have right now,
it will not surprise me at all
if we find out that people who have severe COVID-19
are at an increase risk of stillbirth.
I don't think that we are going to find the asymptomatic
or mild disease causes an increased risk of stillbirth.
However, like many respiratory viruses,
we have seen patients who have stillbirth
because they are severely ill.
Anytime the person who's pregnant is very ill,
it's going to affect the fetus.
And I think that when we tease out this data,
we may see an association.
That is a presumption.
We don't know for sure.
And the data is mixed.
Are babies born to people who are positive for COVID-19
at an increased risk of neonatal problems?
There are a few case reports of babies who get infected
at the time of delivery or in the days after
and who ended up being very sick.
However, this is pretty unusual.
About 95% of babies who are born to someone
who is COVID-19 positive are doing extremely well,
as in not showing any signs or symptoms
of anything being wrong.
The 5% of babies who might be showing signs or symptoms
or getting infected in those first few days
are still doing really, really well for the most part.
So the chances of you having COVID-19
at the time of delivery and that causing major problems
in your newborn is really, really rare.
That being said,
we still don't know the long-term effects
of having COVID-19 during infancy.
So I want you to continue to be diligent
while you are pregnant to protect yourself,
of course, we've talked about all of these risks before,
but also to protect any unknown outcomes for yourself
and for your baby.
Wear a mask, socially distance,
and please, please, please get vaccinated,
which we're gonna talk about in the next video.
Are there treatments for COVID-19 in pregnancy?
Like with COVID-19 treatment outside of pregnancy,
we do have some options.
However, all of these are either experimental
or emergency use authorized,
and none of them, none of them have good data in pregnancy.
So, although we have some options,
I would continue to encourage you to please be diligent,
protect yourself, socially distance,
wear a mask, and please, please, please get vaccinated.
The next video in this series
is going to be talking about the vaccination
during pregnancy, if it is effective, if it is safe,
and if there are other concerns such as infertility
or pregnancy loss associated with vaccination.
Come back here, I will post it in the next few days
and we will talk about it then.
Thanks for being here today, y'all.
If you missed my last episode of ObGyn Reacts
to "I didn't know I was pregnant",
it is my favorite episode ever.
So if it didn't pop up in your notifications,
I'm gonna put it right over here
and you should really go watch it.
It's so good.
If you learned something, leave a like on this,
subscribe if you're not already,
and I will see you next Monday.