Updated: June 25, 2021 10:12:38 am
PREGNANT WOMEN and their newborns in low to middle-income countries (LMICs) are at a higher risk of adverse outcomes due to Covid-19 than their counterparts in high-income countries (HICs), a new study by scientists at Indian Council of Medical Research (ICMR)-National Institute for Research Reproductive Health has said.
Compared to high-income countries, there was a six-time higher risk of abortion and two-time higher risk of stillbirth in women with Covid-19 in the LMICs, the study has found with authors stating that pregnant women must be considered as high priority for vaccines to reduce the adverse impact of Covid-19 in the LMICs.
Scientists studied published articles on Covid-19 and pregnant women from March 1-December 31, 2020. They analysed data of more than 10,582 women from across the world through 225 research publications. The data from 35 countries were assembled systematically and compared between HICs, which included countries like the US, UK, Japan, Italy and Sweden and LMICs, which included data from Brazil, China, India, Iran and others.
The study, “Differential Impact of Covid-19 in Pregnant Women from High-Income Countries and Low-to Middle-Income Countries: A Systematic Review and Meta-Analysis”, was published in “International Journal of Gynecology and Obstetrics” on June 23.
Dr Rahul Gajbhiye, lead author of the study, told The Indian Express that it was worrisome that women with Covid-19 in the LMICs had eight times higher risk of death than their counterparts from the HICs.
“Thus, Covid-19 is likely to have an adverse impact on maternal mortality rates (MMR) in the LMICs,” Dr Geetanjali Sachdeva, director of ICMR-NIRRH. Of the 10,582 women from 35 countries, majority data – 24 per cent was from the US, 11 per cent from India, nine per cent from Brazil, seven per cent from China, Iran and Spain each, six per cent from France and five per cent from the UK.
The co-authors, including Dr Smita Mahale and Dr Deepak Modi, further found that this high risk of adverse outcomes is not because women in the LMICs had more symptoms. On the contrary, the authors found that women in the HICs suffered from more severe Covid-19 related symptoms than those from the LMICs.
“There are many reasons for which women in the LMICs have worse pregnancy outcomes due to Covid-19. Poor access to healthcare services, poor nutrition status and occurrence of other co-infections could be some factors. Also, many women in the LMICs suffer from anaemia and hypothyroidism, and these could also contribute to adverse outcomes of Covid-19,” authors said.
The data highlights that women in the LMICs like India will need special attention in the pandemic. They will require more medical attention and the health system must gear up to keep the maternal mortality rate in check.
Further, pregnant women must be considered a high priority for vaccines to reduce the adverse impact of Covid-19 in the LMICs, authors said.
Nearly 1% maternal mortality in pregnant women due to Covid-19: Data
To address the burden of Covid-19 on pregnant women in India, the PregCovid registry was established by ICMR-NIRRH, along with the Medical Education and Drugs Department and Municipal Corporation of Greater Mumbai.
Dr Gajbhiye, the principal investigator of the PregCovid registry, said there is data on more than 5,600 pregnant women in the registry. Authors find that the maternal mortality in pregnant women due to Covid-19 is nearly 1 per cent (data analysis up to January 31, 2021).
“Further data analysis is on to address the specific medical issue pregnant women might face in India due to the pandemic,” Dr Gajbhiye added.
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