One in 10 Covid positive pregnant women in state 'symptomatic'

Twelve per cent of Covid-positive pregnant women in Maharashtra, close to their due dates, were symptomatic, while 88 per cent were asymptomatic, according to a study. The pan-Maharashtra study was conducted by the Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Parel, in association with Medical Education and Drugs Department (MEDD) and BYL Nair Hospital.Gynaecologists in the city and state have cautioned about the higher risk of health complications among infected mothers, including abortions and post-partum haemorrhage (PPH).

The ICMR-NIRRH, in collaboration with the MEDD, has set up a registry of pregnant women with Covid-19, called PregCOVID (https://pregcovid.com/). Currently, the PregCOVID registry is collecting data from 18 government medical colleges in Maharashtra and the civic-run BYL Nair Hospital.

Dr Smita Mahale, director, ICMR-NIRRH, Dr Rahul Gajbhiye, principal investigator of the study and DBT Wellcome India Alliance Clinical & Public Health Intermediate Fellow, ICMR-NIRRH, Dr Deepak Modi from ICMR-NIRRH, Dr Rajesh Waghmare from MEDD and Dr Niraj Mahajan from the BYL Nair Hospital are the main authors of the study.

The authors of the study had collected data from PregCOVID between April 25 and May 20 from 15 hospitals in Maharashtra and from the BYL Nair Hospital, one of the dedicated Covid-19 hospitals in Mumbai. The study, titled 'Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India' was published in the European Journal of Obstetrics & Gynaecology and Reproductive Biology on September 23.

Dr Gajbhiye said the ICMR had implemented universal testing for SARS-CoV-2 in pregnant women from April 20. "As part of the PregCovid study, we wanted to examine the outcome of the implementation of universal testing policy in pregnant women in Maharashtra. The study population constituted both urban and rural," he said.

“Of the 1,140 registered pregnant women, 321 of them had contracted SARS-CoV-2, of which only 37 (11.5 per cent) showed symptoms such as cough, cold, fever, loss of smell, diarrhoea and breathlessness among others during admission, or those likely to deliver in the following five days,” he said. “Our study estimated that one in 10 pregnant women was symptomatic,” he added.

Dr Smita Mahale, director, ICMR-NIRRH said, "This is a preliminary observational study, restricted to Maharashtra. It can't be generalised for the country as a whole."

Dr Deepak Modi, head of the molecular and cellular biology laboratory, ICMR-NIRRH, said “Pregnant women's bodies are more vulnerable because the immune system is weak and lungs are stressed. This could be one reason why we see such high numbers. Pregnant women must protect themselves with masks and minimise social contact.”

Doctors have observed that Covid-19 does contribute to health complications for the mother and the fetus, especially among women with gestational diabetes, a condition in which blood sugar shoots up during pregnancy.

Dr Ashok Anand, head of obstetrics and gynaecology, JJ Hospital, said they have treated around 600 pregnant women with Covid-19 infection since the lockdown was implemented in March. They have observed how pregnant women are more susceptible to the infection because of low immunity. “Due to low immunity, pregnant women develop more health issues,which lead to further complications in pregnancy. We have also witnessed abortion and malformation of the fetus but cannot link it directly to the infection, as there is not enough scientific proof," he said.

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