As researchers around the world urgently try to understand how the Covid-19 virus can affect pregnancy and babies, some answers are starting to emerge.
The most comprehensive review available on international research on the subject has been published in the British Medical Journal by the British University of Birmingham, containing 77 studies with a total of 11,432 pregnant and recently pregnant women hospitalised with Covid-19.
The study found pregnant women hospitalised with Covid-19 are more likely to give birth early, be admitted to intensive care and their baby be admitted to neonatal care.
"But overall rates of spontaneous pre-term births are not high. Stillbirth and neonatal death rates are low in women with suspected or confirmed Covid-19," the report states.
The overall preterm birth rate for women hospitalised while pregnant with Covid-19 was 17 per cent, and for natural preterm birth, it reduced to six per cent.
“There didn't seem to be a lot of natural sort-of early bringing on. It’s usually because mum’s so sick and then that doesn't help the baby if mum's sick,” Victoria University professor Bev Lawton said.
The review also found expectant mothers that are older, overweight or have pre-existing medical conditions have a higher risk of having a severe case of the virus.
Lawton said while New Zealand expectant mums have a lower risk of contracting the virus, the review reinforces the need for pregnant women to get medical care and follow Covid-19 health precautions.
“This is really a strong message for pregnant women out there who haven't had your influenza vaccine - please go and have that vaccine because that will prevent a lot of problems,” she said.
In New Zealand, 19 women have had Covid-19 while pregnant.
Hazel Lund, a Wellington mother of two including a six-week-old boy, says more research is needed to put pregnant women's minds at ease during the pandemic.
“The more research the better… but that’s going to take time 'cause they need to get all the information together and make sure that they’re doing thorough literature review and studies to make sure that we are informing and we’re not just scaremongering as well, which when you read that, it can be a little bit like that,” Lund said.
“The biggest thing I think is to be able to know that you can reach out and you can approach your midwife or your not scared to go to your doctor. You want to be able to have the confidence to do that… Amongst the pandemic it’s more important that you have access to that kind of health care.”
Lund’s husband and six-week-old Toby’s dad, Tim Bush, said bringing life into the world during a pandemic was “a turbulent time”.
“Also grateful for where we live in the world,” he said.
The family are waiting to find out when Lund’s British family will be able to travel to New Zealand to meet their grandson and are taking a little time for Bush’s Auckland-based father to visit after the latest outbreak.
Midwife Denise Garcia said working during the pandemic has been a stressful time for colleagues and herself too.
“[There's] a lot more talking around safety. A lot of families are not able to support or be here, and they’ve got worries for family,” she said about her clients.
“Keeping ourselves safe, keeping our mums safe, has been huge for us.”
Garcia said the British Medical Journal review is very useful.
“Because we need to be more aware and more onto our testing and encouraging people to go and get their tests - their tests for diabetes and things like that - done, which happens in the pregnancy,” she said.
Garcia said it’s up to midwives to make sure clients turn up to appointments and inform them of any health concerns.
A limitation of the review is that while the findings were based on a large number of cases, they come from a small number of studies, the review states.
Researchers hope as the review continues to be updated with new studies it will form a strong evidence base for countries’ policy makers, health professionals and expectant mothers.
They say the health sector should be aware that expectant mums with the virus may need access to intensive care and specialist facilities for babies.
A Ministry of Health spokesperson said in a statement New Zealand’s district health boards have the ability to increase intensive care beds and the health system is prepared for a situation where the country has more Covid-19 cases.
The ministry acknowledged the review and said it’s closely monitoring new research on the risk to pregnancy from Covid-19.
The ministry’s website states pregnant women are at a higher risk during the pandemic and should increase health precautions to reduce their risk of catching the virus.
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