56 percent of pregnant women in UK hospitals with COVID-19 are BAME

By Dr. Ananya Mandal, MDJun 8 2020

According to a new national surveillance study released this week, over half of the pregnant women admitted to a hospital in the United Kingdom with COVID-19 are either black or belong to other ethnic minority groups.

The study titled, “Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population-based cohort study,” on behalf of the UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group, was published in the latest issue of the journal British Medical Journal.

What was the study about?

The team of researchers wrote that there is little evidence regarding the transmission of COVID-19 caused by the SARS-CoV-2 virus among mothers and newborn babies. There are small case series and case reports of such transmission, but extensive studies and reports are lacking, the team writes.

They wrote, “To the best of our knowledge, as of 12 May 2020, more than 90 scientific reports of SARS-CoV-2 infection in pregnancy had been published in English, none of which was population-based.” In addition, most of the cases reported were among women in their third trimester of pregnancy.

They also explain that, like other viral infections and transmissions, pregnant women are also more susceptible to getting infected with COVID-19 due to their altered immune status. This could significantly raise the risk of “maternal and neonatal morbidity and mortality,” they wrote.

This study aimed to describe a cohort of pregnant women across the nation admitted to the hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study also recorded the outcome of such infections, their transmission from mother to newborn babies.

Study: Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. Image Credit: Yaw Niel / Shutterstock

What was done?

This study was designed in 2012 and was planned on being conducted in the event of a pandemic. The study was thus activated by the UK Department of Health and Social Care during the COVID-19 pandemic. The researchers used the UK Obstetric Surveillance System (UKOSS) to assess the prevalence of the infection among 427 pregnant women and the outcome. They wrote that the “UKOSS is a research platform that collects national population-based information about specific severe complications of pregnancy from all 194 hospitals in the UK with a consultant-led maternity unit.” The research team was led by Professor Marian Knight from the Nuffield Department of Population Health, University of Oxford.

Infection in pregnant women was confirmed by the detection of viral RNA on polymerase chain reaction (PCR) using blood tests of samples from nasopharyngeal swabs. Only women with symptoms were tested for SARS-CoV-2 infection. Detection of the virus via PCR in the nasopharyngeal swab and aspirate in the newborn also confirmed the diagnosis.

The data was collated in the UK’s National Institute of Health Research Clinical Research Network by the research midwives and nurses. All women admitted to the hospital between 1 March and 14 April 2020 were included. Those women who had complete information up until 29 April 2020 were included in the final analysis.

The outcomes measured and taken into account were the rate of admission of the pregnant mothers to hospitals, infection in the infants, rate of deaths among the mother or need for level 3 critical care admission, loss of the baby, need for cesarean section, giving birth to a premature baby or stillborn baby and admission of the newborn to the neonatal ICU.

What was found?

The results showed that the estimated incidence of hospital admission among pregnant women with confirmed COVID-19 infection was 4.9 per 1,000 maternities. They found that 56 percent of the mothers analyzed (233 women) were from black or other ethnic minority groups. They also noted that 281 women or 69 percent were either obese or overweight, and 175 women or 41 percent were aged over 35 years. Pre-existing diseases were seen among 34 percent of women (145 women).

Regarding the outcome, they noted that 62 percent of women or 266 gave birth or lost their pregnancy. A total of 196 women or 73 percent gave birth to term babies, while others were preterm. A further 10 percent of pregnant women needed respiratory support on admission to the hospital, and 1 percent of women (5 of them) died during the course of the illness.

Among the babies, 5 percent or 12 tested positive for the infection from their mother, and six of these were positive within 12 hours after their birth.

Conclusions and implications

This study pointed out that over half of the pregnant women admitted to UK hospitals with COVID-19 were from black or other ethnic minority groups. They also noted that the outcomes of these women were generally good, and the risk of transmission to new-borns was low.

The authors said that the high proportion of admitted women who were black or belonged to ethnic minorities was a cause of concern and needed further investigation.

They wrote, “The high proportion of women from black or minority ethnic groups admitted with SARS-CoV-2 infection needs urgent investigation and explanation.”

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