Pregnant women infected with the novel coronavirus stand a higher risk of becoming severely ill, according to health care professionals who have been monitoring COVID-19’s adverse impacts on expectant mothers and their infants.
Thousands of pregnant women across Southern California have tested positive for the novel coronavirus in the past six months. And while two women with preexisting health conditions have died from the virus, medical professionals say most have recovered from their illnesses, and most babies born to COVID-19-infected mothers have tested negative for the virus.
According to the Centers for Disease Control, 20,798 pregnant women in the United States tested positive for COVID-19 from Jan. 22 to Sept. 8.
Not only are pregnant women at greater risk for severe illness compared to non-pregnant women, the CDC says, but pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes, such as preterm birth.
Doctors weigh in
At Providence St. Joseph’s of Southern California, which operates 10 hospitals in Orange, Los Angeles and San Bernardino counties, more than 15,000 pregnant women have delivered babies in the past six months, and 1-2% of them — 150 to 300 women — tested positive for COVID-19, said Dr. David Lagrew, medical director of women’s services at Providence.
St. Joseph Hospital in Orange, which handles about 300 to 400 deliveries a month, has had the highest number of COVID-19-infected pregnant patients on a weekly basis in the Providence system, Lagrew said.
“Nine to 10% of the people walking through the door were COVID-positive,” Lagrew said, noting that the majority of the women who tested positive for the potentially deadly virus were asymptomatic at the time they were tested.
Few expectant mothers, however, became severely ill, Lagrew said.
“We’ve had three, maybe four mothers who have had to go into intensive care with more severe illnesses,” he said.
Dr. Yu Chen, an OB/GYN at Beverly Hospital in Montebello, said about 5% of the pregnant women he has treated since March tested positive for the novel coronavirus. Chen said none of the women required hospitalization, but rather were told to self-quarantine at home.
“I haven’t encountered anybody who’s had any long-lasting effect,” Chen said, adding that the recovery rate for his COVID-19-infected patients is 100 percent, and none of the babies born to mothers infected with the virus has tested positive for it.
Expectant mom feared virus
Pomona Ramos, a patient of Chen’s who delivered a healthy daughter, Nellie, on Tuesday, Sept. 8, at Beverly Hospital, said the fear of contracting COVID-19 weighed heavily on her mind while she was pregnant.
“I was worried about it all the time,” said Ramos, 25, of Montebello, in an interview. “Me and my husband, we got tested twice, first when we found out I was pregnant and again later on. We are COVID-free.”
Pomona Valley Hospital Medical Center, the largest birthing hospital in Los Angeles and San Bernardino counties, documented its first pregnant patient infected with COVID-19 on April 1. Since then, 59 pregnant women have tested positive for the virus, said Dr. M. Hellen Rodriguez, an OB/GYN and medical director of maternal-fetal medicine.
Of those 59 patients, 44 were asymptomatic when they were tested, 10 experienced mild symptoms, three had severe symptoms and received treatment in a telemetry unit, and two had severe symptoms that required treatment in the hospital’s intensive care unit, Rodriguez said.
“We’re pleased that all of our mothers and their babies were discharged,” Rodriguez said.
Still, several patients who have tested positive for COVID-19 have yet to deliver their infants.
“This is important to note because it confirms that the virus is still prevalent and spreading in our communities,” Rodriguez said. “Our asymptomatic case rates are particularly concerning as they stress the need for pregnant women to take all necessary precautions to protect themselves and their babies.”
As health care professionals prepare for the convergence of the COVID-19 pandemic and flu season, they are strongly encouraging all pregnant women to get the influenza vaccine, continue staying home, practice good hand hygiene, wear a mask and social distance, Rodriguez said.
What studies show
A study conducted in April by researchers at the Icahn School of Medicine at Mt. Sinai, and published in the August edition of “Obstetrics & Gynecology,” found that of 155 pregnant women tested for COVID-19 from April 4 to April 15, 15.5% of them tested positive for the novel coronavirus.
Additionally, 58% of their asymptomatic partners and/or support persons tested positive for it, according to the study.
Dr. Angela Bianco, an OB-GYN at Mt. Sinai Hospital in New York City and lead author of the study, said it was one of several conducted in April to better understand the impacts of COVID-19 on pregnant women and their babies.
Another study of more than 200 COVID-19-infected pregnant patients across five New York City hospitals found that 80% suffered mild symptoms prior to recovery, while 15% became severely ill and 5% critically ill, Bianco said.
Medical and health care professionals agree that pregnant women are at no more risk of contracting the novel coronavirus than anyone else, but maintain pregnant women are more prone to infection and becoming severely ill if they contract COVID-19.
“Right now, we think that chance of getting the (coronavirus) during pregnancy is about the same as the general public. But if a pregnant mom gets the virus, she is more likely to be hospitalized, more likely to need admission to the intensive care unit, and more likely to need mechanical ventilation,” said Kristina Roloff, a doctor of osteopathic medicine in the Women’s Health Department at Arrowhead Regional Medical Center in Colton, which is operated by San Bernardino County.
Roloff said the hospital’s high-risk obstetrics team is studying how many pregnant patients are carrying the novel coronavirus at the time their babies are born. Preliminary results, according to Roloff, suggest up to 15% of women delivering at ARMC have antibodies against the coronavirus, which suggests that many moms are being exposed to or developing a COVID-19 infection.
Research indicates that only 1% to 3% of babies born to COVID-19-infected mothers have the novel coronavirus, but mothers who contract the virus in the first trimester are more likely to miscarry, Roloff said.
Latinas and Blacks at higher risk
Latina women comprised the majority of pregnant patients who tested positive for COVID-19 at Providence Southern California’s 10 hospitals in Orange and Los Angeles counties, including St. Joseph Hospital in Orange. And the hospitals with the highest rates of pregnant women infected with COVID-19 are in communities serving large Latino populations, Lagrew said.
Along with St. Joseph Hospital in Orange, Providence Little Company of Mary Medical Center in Torrance and Providence Holy Cross Medical Center in Mission Hills have had the highest numbers of COVID-10-positive pregnant women in the system, Lagrew said.
According to the Centers for Disease Control, Latinas and Blacks are at higher risk of contracting the novel coronavirus and becoming hospitalized during pregnancy.
A 32-year-old Hesperia woman who died on June 26 from COVID-19 after her child was delivered was Black, according to San Bernardino County public health officials. Health officials in Los Angeles County would not provide any information on a pregnant woman who died on June 1, other than to say she suffered from preexisting medical conditions as well.
Quick and unexpected
Blanca Estela Rodriguez Madrigal is among the more than 300 pregnant women in San Bernardino County who have tested positive for the novel coronavirus. She said the virus hit her quickly and unexpectedly.
She was seven months pregnant when on the evening of July 23, her breathing became labored as she sat watching television with her family in her Adelanto home.
“It felt like someone was suffocating me with a pillow,” Rodriguez Madrigal said. “It was just all of a sudden.”
At Loma Linda University Children’s Hospital, Rodriguez Madrigal was diagnosed with pneumonia, which progressed to respiratory distress syndrome. She was put into a medically induced coma and her daughter, Jade, was delivered via C-section on July 26, said her doctor.
Jade remains in the neonatal intensive care unit at Loma Linda University Children’s Hospital. She has tested negative for the virus.
Rodriguez Madrigal strongly encourages expectant mothers to heed the advice of medical professionals in protecting oneself against the potentially deadly COVID-19.
“Put on your masks and be very, very cautious,” she said. “Use hand sanitizer, wash your hands, stay 6 feet apart from people, and don’t go out if you don’t need to — even put masks on your kids. Anybody could get this.”
By the numbers
In Los Angeles County, more than 1,200 pregnant women have tested positive for COVID-19, and, in Orange County, more than 170 pregnant women have been diagnosed.
Dr. Jennifer Butler, an OB/GYN at UCI Medical Center in Orange, said 3.5% of the more than 600 pregnant women tested for COVID-19 from April through August were positive for the virus.
At Riverside University Health System Medical Center, 37 pregnant women admitted to the hospital in the past six months have tested positive for COVID-19. One woman suffered severe respiratory failure and was admitted into the ICU, said Dr. Bryan Oshiro, vice chairman of obstetrics/gynecology and director of maternal and fetal medicine. Fortunately, he said, said none of the babies birthed from COVID-19-infected mothers had tested positive for the virus.
Advocates on standby
MOMS Orange County, a Santa Ana nonprofit that for nearly 30 years has advocated for pregnant women from underserved communities and offers classes on prenatal education and childbirth preparation, has 50 clients who have tested positive for the novel coronavirus, said CEO David Lugo
Additionally, 12 infants and 40 family members of MOMS’ clients also have tested positive for the coronavirus, Lugo said.
“The COVID issue has not only hit our clients and their families from a health perspective but also, obviously, from a financial and employment perspective,” Lugo said in an email. He said MOMS has been consulting its COVID-19 clients weekly to more closely monitor their status and the health of their unborn or newly born babies.
“During these weekly visits we are also providing the most up-to-date guidelines, directing them toward all resources we may know about to help them with their health, financial situation, employment situation, etc.” Lugo said.
Source: Orange County Register