The COVID-19 pandemic has presented novel challenges to global health. Understanding the virus’s effects on the human body, particularly during pregnancy, remains a focus of ongoing research. This article examines the current evidence to clarify how COVID-19 may influence pregnancy outcomes and its specific impact on fetal health.
Does COVID-19 Increase Stillbirth Risk?
Scientific studies indicate that COVID-19 infection during pregnancy is associated with an increased risk of stillbirth. A population-based study of over a million delivery hospitalizations in the United States from March 2020 to September 2021 revealed that pregnant individuals with COVID-19 had a higher risk of stillbirth compared to those without the infection. This association was particularly pronounced during the period when the SARS-CoV-2 Delta variant was dominant. Unvaccinated pregnant individuals who contracted COVID-19 faced a significantly elevated risk of stillbirth or neonatal death.
Research from Scotland further supports these findings, showing that pregnant women diagnosed with COVID-19 experienced higher rates of preterm birth, stillbirth, and newborn death. Nearly all such adverse outcomes occurred in women who were unvaccinated at the time of their COVID-19 diagnosis. For instance, the rate of perinatal deaths among women with COVID-19 was reported as 22.6 deaths per 1,000 births, considerably higher than the background rate of 5.6 per 1,000 births. These studies underscore that while stillbirths linked to COVID-19 are not common, the infection does increase the statistical likelihood.
How COVID-19 Can Affect Fetal Health
COVID-19 can affect fetal health primarily through its impact on the placenta, the organ responsible for nutrient and oxygen exchange between mother and fetus. The virus can lead to SARS-CoV-2 placentitis, characterized by significant damage to placental tissues. This damage often involves widespread deposition of fibrin, a protein involved in blood clotting, and necrosis within the placenta’s protective layers. Such extensive damage can compromise the placenta’s ability to function properly.
The observed placental abnormalities include insufficient blood flow from the mother to the fetus and the formation of blood clots within the placental blood vessels. These changes can severely limit the delivery of oxygen and nutrients to the developing baby, potentially leading to asphyxiation. While direct viral infection of the fetus is uncommon, the severe placental injury can render the organ incapable of sustaining the pregnancy.
Protecting Pregnancy from COVID-19
Protecting against COVID-19 during pregnancy involves vaccination as a primary recommendation. Health organizations, including the Centers for Disease Control and Prevention (CDC), advise COVID-19 vaccination for all eligible individuals, including those who are pregnant, breastfeeding, or planning to conceive. Studies demonstrate that COVID-19 vaccination before and during pregnancy is both safe and effective, offering benefits to both the pregnant person and the baby.
Vaccination helps reduce the risk of severe illness, hospitalization, and death from COVID-19 for the pregnant individual. It can also provide passive immunity to newborns, as antibodies generated by the mother’s vaccination can cross the placenta, offering protection to infants in their early months when they are too young to be vaccinated.
Alongside vaccination, adhering to public health guidelines remains important:
- Maintaining physical distance from others.
- Avoiding crowded indoor spaces.
- Ensuring good room ventilation.
- Practicing frequent hand hygiene with soap and water or alcohol-based rubs.
Wearing a well-fitting mask when adequate distance cannot be maintained also adds a layer of protection. If COVID-19 symptoms develop during pregnancy, seek prompt medical advice from a healthcare provider, informing them of your pregnancy status.