Gynecology and obstetrics specialists from Spain have urged regional authorities to speed up immunisations of pregnant women following three deaths in the last month and a sharp rise in admissions to the ICU.
“We are at a very fragile moment,” says Guillermo Antiñolo, head of obstetrics and gynecology at Virgen del Rocío Hospital in Seville. “The ICUs are under great strain. We have to vaccinate, vaccinate and vaccinate pregnant women and do it quickly.”
Pregnant women are in “the middle of a perfect storm” that has formed in the last months due to the less than strong recommendations on the vaccination of this group, according to Martínez Pérez.
Óscar Martínez Perez, a leading researcher at ObsCovid, a registry for maternity healthcare workers who assist patients with suspected or confirmed COVID-19, agrees that the situation is dire. “We are in the worst moment of the pandemic for these patients,” he says. Pregnant women are in “the middle of a perfect storm” that has formed in the last months due to the less than strong recommendations on the vaccination of this group, according to Martínez Pérez. Several recent studies have shown that contracting COVID-19 increases the risk of pregnancy complications by 50%, and that the vaccine is safe for baby and mother.
Three pregnant women reportedly died from COVID-19 in the last month in Spain - in Barcelona, Málaga and Murcia, however specialists warn the real figure could be far higher as the registry system is not comprehensive. They also note that there have been a number of fetal deaths in at least Madrid and Mallorca, and “numerous urgent C-sections due to the worsening state of the expectant mothers,” says Martínez Pérez. “We are saving many women because we have a very capable healthcare system, but in some cases, we are cutting it close and we will have to see what the scars are of the long-term admissions in ICUs.”
Experts say the complication of most concern is preeclampsia, a serious disorder that can lead to increased arterial pressure and liver and kidney problems. COVID-19 induced preeclampsia endangers the life of the mother and fetus, and if it is not controlled, an emergency caesarean delivery must be performed, often much earlier than is preferred for the baby.
According to Spain’s vaccination strategy, pregnant women should be vaccinated according to the priority group they belong to. However, it seems that the message that pregnant women should be vaccinated simply has not been strong and clear enough.
Regional Health Chief Josep Maria Argimon admitted last week that “we are seeing many more pregnant women with Covid,” and insisted that this group should get vaccine appointments. The Catalan government is planning to hold a news conference in the coming days focusing specifically on pregnant women.
In the US, one of the countries with the greatest access to vaccines, a June 2021 study from the CDC showed that pregnant women are getting vaccinated against COVID-19 at a lower rate than their non-pregnant peers, and the rate is particularly low among those aged 18 to 24 as well as Black and Hispanic women.
"We have work to do as far as informing pregnant persons about the benefits of receiving COVID vaccine in addition to highlighting their increased risk for complications, severe COVID infection, if they become symptomatic," said Dr. Malini DeSilva, a researcher at HealthPartners Institute who was one of the study authors.
In the paper, researchers wrote: "Although low, COVID-19 vaccination coverage among pregnant women is expected to increase as vaccine availability and access improve, and as more safety data become available."