As the Covid-19 pandemic surges on, scientists are racing to understand more of the novel disease and its impact on patients, especially those who are pregnant. During pregnancy, female patients experience immunologic and physiologic changes that could increase their risk for more severe illness from respiratory infections, explains Cynthia Gyamfi-Bannerman, MD, MSc, of the Preterm Birth Prevention Center at Columbia. These risks make a respiratory disease like the coronavirus especially relevant for pregnant patients and their healthcare providers.
Researchers from the Centers for Disease Control (CDC) analyzed preliminary results from more than 90,000 female patients who had been diagnosed with Covid-19 since the US outbreak; roughly 9,000 were pregnant at the time. “At first glance, this looks very concerning,” says Dr. Gyamfi-Bannerman. Pregnant patients were more likely to be admitted to the hospital, the intensive care unit (ICU), or require mechanical ventilation when compared to patients who were not pregnant. This analysis, however, doesn’t tell the full story, explains Dr. Gyamfi-Bannerman.
“What people need to understand is that we don’t currently have a lot of detailed data on Covid in pregnant patients. These current data can’t tell us if the hospital and ICU admissions were secondary to delivery stays or pregnancy complications.” What this means is that none of these results — the higher hospitalizations and ICU admissions — can be attributed to Covid, since many pregnant women with COVID are asymptomatic and get tested when they come to deliver. As for mechanical ventilation, Dr. Gyamfi-Bannerman also points to the unfortunate high-risk morbidities that are associated with pregnancy that may have been the reason for some of the mechanical ventilation, not coronavirus.
Scientists are looking at more specific data as more patients emerge with Covid-19, she adds. With more details in reporting, more analyses can be done to determine the impact of the disease on pregnant patients specifically. “We’re looking at more complex and granular data every day to learn more about the coronavirus’s impact on pregnant women and what additional safety measures to enforce,” says Dr. Gyamfi-Bannerman
With only high-level data, there are many questions left unanswered about the safety of pregnant patients during the pandemic, but Dr. Gyamfi-Bannerman has some recommendations. “One of the biggest pieces to take away is that pregnant patients should be closely following the state’s requirements,” explained Dr. Gyamfi-Bannerman. She points to New York’s virus precautions, like mask-wearing, limiting public exposure, and maintaining social distancing, as a minimum for what pregnant patients should do during the pandemic.
As for care, Dr. Gyamfi-Bannerman discusses the strict protocols enacted at Columbia for slowing the spread of the disease. Waiting rooms have been rearranged, telehealth appointments are being made when possible, and limiting the number of patients seen each day has helped Columbia University keep patients safe. Internal data from the Department of Surgery at Columbia suggests that even during the peak of the Covid-19 crisis in the New York metro region, less than 1% of patients contracted the virus after visiting the hospital.
“It’s really important for patients to understand we’re looking at data at Columbia to fill the holes we see in the CDC data,” adds Dr. Gyamfi-Bannerman. She and other experts are part of a nationwide, government-funded study to look at outcomes related to pregnancy in covid patients in more granular detail.
For more information on how Columbia University is keeping its medical facilities Covid-free, read an interview with our facilities manager, Francine Castillo.
To learn more about Columbia’s telehealth options, read this piece on our video visits, and see if your provider is able to minimize your public interaction while still balancing the quality care Columbia is known for.