The global Covid pandemic started about 2 and a half years ago. Since then, there have been
a number of studies about covid infection in pregnancy but the focus of research has been on
pregnant people with infections in second and third trimesters. These studies confirmed our
worst fears. Covid infections in pregnant people are more likely to result in severe illness,
hospitalization, ICU admission and death than in non pregnant people. Pregnancy complications
such as preterm delivery and pre-eclampsia
occur more commonly and there is a higher chance for fetal death. Some questions have
not yet been adequately answered such as does a mild Covid infection in the first trimester
increase the risk for miscarriage? A new study may help us get a little closer to an answer
The
COVID-19 Contraception and Pregnancy Study (CAP-COVID) was an online study conducted in
the U.K. People who registered early in their pregnancy were sent a questionnaire at the end
of their first trimester. Participants were asked if they had an ongoing pregnancy or whether they
had experienced a miscarriage; had an abortion or some other pregnancy complications such as a
tubal pregnancy. Participants were also asked whether they had symptoms of Covid infection;
had been diagnosed with a covid infection; or whether anybody in their household were
diagnosed or had symptoms of a covid infection. Based on their answers,
they were divided into three groups; presumed infection, presumed not infected or uncertain.
In total, over 3000 pregnant people were studied. The percentage of miscarriages in the
covid infection group was 14%. By comparison, only 8% miscarried in the uninfected group
and only 5% miscarried in the group in which a household contact was infected.
At first glance, it would appear that a first trimester infection with covid
nearly doubled the risk for miscarriage. Of greater concern,
these were very mild infections. In fact, 5% of the Covid infections had no symptoms at all.
For those people that did have symptoms, over 80% reported fatigue and about ⅔ reported
loss of taste or smell and about ⅔ reported headaches. Other symptoms were less common.
This study is far from perfect, however. Although it is the largest study yet to look
at this problem, there were still only 77 people in the group with infection.
Another area of concern is that the miscarriage rate in the non infected group
was lower than expected for a group like this. It is possible that there
were miscarriages that occurred earlier in pregnancy that were not recognized.
At this point, we still cant say with certainty that mild 1st trimester covid infections cause
miscarriage. It would not be surprising if they did, however. A number of viral infections have
been associated with a greaterer risk for miscarriage including the flu virus. A big
problem with Covid is that so many pregnant people are becoming infected every few months. Even a
small increase in miscarriage risk translates into a very large number of extra miscarriages.
Our Infertility TV medical recommendation is this. People planning to become pregnant
should be vaccinated first to reduce the risk of contracting Covid. Pregnant people
should take extra precautions to reduce the risk of contracting Covid
such as mask wearing and reducing close contact with others indoors.