Unvaccinated pregnant women at risk of stillbirths

What you need to know:

A study of pregnancies complicated by Covid-19 infection identified placental abnormalities, suggesting that inflammation might occur with maternal Covid-19 infection. A high concentration of the Covid-19 virus in the mother’s blood makes it more likely to cause stillbirths.

Expectant mothers who have contracted Covid-19 and have not been vaccinated have higher chances of getting stillbirths, a combination of research studies now show. 

A survey by Cleveland Clinic in the United States reveals that the Delta variant caused severe effects.

Dr Amy McKenney, who was part of the research team, said that while it was not clear if the virus caused stillbirths, the Delta wave in the second year of the pandemic caused tragic outcomes of pregnancy.

The study shows that a high concentration of the Covid-19 virus in the mother’s blood makes it more likely to infect and damage the placenta in women.

“We have never seen complications in a fully vaccinated woman, the only way to keep the virus away from the placenta is by having the mother fully vaccinated,” noted Dr McKenney.

She added that there exists no mechanism to repair the placenta in such a situation, and the only option would be to do an early delivery. Last February, a 44-member international research that team studied 64 stillbirth cases and four early neonatal deaths from 12 countries on unvaccinated mothers concluded that Covid-19 infection destroyed the placenta, depriving the foetus of oxygen.

The survey, published in Archives of Pathology and Laboratory Medicine, established that when the virus reaches the placenta it causes it to fail by passing through the mother’s bloodstream, a process known as viremia.

“Our study identified placental insufficiency as the root cause for stillbirths in women with Covid-19 during pregnancy,” said Dr David Schwartz, an Atlanta-based pathologist who led the study.

Among the 68 cases, an average of 77 per cent of the placenta had been destroyed and rendered useless for supporting critical foetal needs, resulting in a stillbirth or early neonatal death.

In almost all the cases, researchers also found increased fibrin – a key protein involved with blood clotting – was so “massive” that it blocked blood and oxygen flow to the placenta.

Placenta complications

All the placentas also showed dead cells made up the major cell barrier between the mother and foetus, known as trophoblast necrosis.

Another placental complication that may have been caused by the virus was a rare accumulation of inflammatory cells called chronic histiocytic intervillositis, which was seen in 97 per ent of cases studied by the scientists.

According to a Centres for Disease Control and Prevention report published last November, a total of 8,154 stillbirths were documented in the United States, affecting 0.64 per cent and 1.26 per cent of deliveries without Covid-19 and with Covid-19, respectively.

“A study of pregnancies complicated by Covid-19 infection identified placental histopathologic abnormalities, suggesting that placental hypoperfusion and inflammation might occur with maternal Covid-19 infection,” the survey states.

However, it notes that further investigation of vaccine effectiveness during pregnancy, including prevention of stillbirth, is warranted.

The findings point to a threat among Kenyan families as only 8.1 million people have been fully vaccinated out of a population of 50 million, accounting for only 30 per cent of the population.Campaigns by the Ministry of Health in the past months to have more Kenyans vaccinated have been unsuccessful.