Study Warns of ‘Severe’ Impact from COVID-19 on Obstetric Care

Even though many pregnant women often don’t otherwise fall into high-risk categories for the novel coronavirus, a new study documents why they are right to be concerned. Researchers predict that obstetrics will be “severely impacted” by the pandemic and that 52 COVID-19 related maternal mortalities will occur in the U.S. this year.

CLEVELAND – Expectant mothers worried about COVID-19’s effect on their pregnancies apparently have good reason to be concerned.

study published online in the journal American College of Obstetrics & Gynecology MFM, projects 52 COVID-19 related maternal mortalities in the United States this year. The study involving researchers from Case Western Reserve University in Cleveland and Georgia State University in Atlanta is touted as the first to forecast the impact of the novel coronavirus on labor and delivery hospitalization.!

“We know that pregnancy alters the immune system, and given the fact that the majority of American women deliver in a hospital setting it creates a unique challenge in the fight against the novel coronavirus,” explained co-author David Hackney, MD, Director, Maternal Fetal Medicine, UH Cleveland Medical Center. “The goal of our research is to best predict the impact of COVID-19 on obstetric care in the United States in order to better prepare maternity units and caregivers.”

“Pregnancy and delivery pose unique challenges, given the altered maternal immune system and the fact that the majority of American women choose to deliver in the hospital setting,” the authors note.

That’s why the team decided to forecast the incidence of COVID-19 in the general population, as well as predicting the overall incidence, severe cases, critical cases and fatal COVID-19 cases during delivery hospitalization in the United States.

To do that, researchers used a phenomenological model with generalized logistic growth models to make the forecast in the United States from 4/15/2020 – 12/31/2020. Used to provide the best-fit model solution was incidence data from 3/1/2020 – 4/14/2020.

The forecast predicts a total of 860,475 cases of COVID-19 in general population across the United States during that time period, with the cumulative incidence for COVID-19 during delivery hospitalization is anticipated to be 16,601 (95% CI, 9,711 – 23,491) cases.

“Among those, 3,308 (95% CI, 1,755 – 4,861) cases are expected to be severe, 681 (95% CI, 1324 – 1,038) critical and 52 (95% CI, 23 – 81) maternal mortality,” the authors write. “Assuming similar baseline maternal mortality rate as the year of 2018, we projected an increase in maternal mortality rate in the US to at least 18.7 (95% CI, 18.0 – 19.5) deaths per 100,000 live birth as a direct result of COVID-19.”

The researchers suggest those risks will “severely impact” obstetrical care.

“To our knowledge this is the first study on the incidence of COVID-19 in pregnancy,” noted principal investigator Manesha Putra, MD, of UH Cleveland Medical Center. “Despite its limitations, this study has the ability to guide resource allocation and better prepare hospitals and caregivers on the frontlines.”

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