The coronavirus disease 2019 (COVID-19) infection rate among pregnant women was estimated to be 70% higher than in similarly aged adults in Washington state, according to a new study published in the American Journal of Obstetrics and Gynecology.

Other key findings of the study include:
  • The number of COVID-19 infections in pregnant patients from approximately all communities of color in Washington was high. There was a twofold to fourfold higher prevalence of pregnant patients with COVID-19 infections from communities of color than expected based on the race-ethnicity distribution of pregnant women in Washington in 2018. 
  • A high number of pregnant women with COVID-19 received their medical care in a language other than English, which the researchers said indicates that public health outreach to enhance vaccination rates in these communities is crucial.

“Our data indicate that pregnant people did not avoid the pandemic as we hoped that they would, and communities of color bore the greatest burden,” said senior study author Kristina Adams Waldorf, in a press release. “We were disheartened to see the higher infection rates in communities of color as well as in patients with limited English proficiency."

COVID-19 vaccine allocation is based priority lists set by each state’s department of health, which can vary. In some states, pregnancy is considered a high-risk health condition for COVID-19 vaccine allocation in phase 1B. States that prioritize pregnant women for the COVID-19 vaccines include Texas, New Hampshire, and Alaska, according to the press release.

“The vaccine distribution plans vary quite a bit, state-by-state, and pregnant women are written out of the allocation prioritization in about half of US states,” Waldorf said in a press release. “Many states are not even linking their COVID-19 vaccine allocation plans with the high-risk medical conditions listed by the CDC, including pregnancy.”

Waldorf added that this study is unique in the United States because it is the first to address the question of infection rates in pregnancy in a large population that represents the majority of pregnancies in the state.

“The data can inform vaccine policy and guide public health workers and physicians in trying to mitigate COVID-19 in vulnerable populations,” she said.

The study included 35 hospitals and clinics that compose the Washington State COVID-19 in Pregnancy Collaborative. The research group identified 240 pregnant women who acquired COVID-19 from March through June 2020. This number represents all such known cases at the collaborating sites, which account for 61% of births in the state each year, according to the study.

"Higher infection rates in pregnant patients may be due to the overrepresentation of women in many professions and industries considered essential during the COVID-19 pandemic, including healthcare, education, service sectors," said study author Erica Lokken, epidemiologist at the UW School of Public Health, in the press release. “Pregnant women may also have larger households, children in daycare or playgroups, and be caregivers within an extended family”

The study data fill critical gaps and provide an important estimate of regional COVID-19 infection rates in the pregnant population, according to Waldorf.

“The Centers for Disease Control and Prevention's estimated infection rates may not be representative,” she added.

Further, Waldorf urges pregnant women to discuss the risks and benefits of COVID-19 vaccination with their prenatal care provider, since more OB-GYNs have begun recommending that pregnant women take the vaccine.

“We want to use information from this study to be more prepared for the next pandemic and to not brush pregnant women to the side. They need to have a seat at the table when it comes to vaccine trials and vaccine allocation,” Woldorf said in the release.

REFERENCE
Study: COVID-19 infection rates high in pregnant women. UW Medicine. https://newsroom.uw.edu/news/study-covid-19-infection-rates-high-pregnant-women. Published February 16, 2021. Accessed February 18, 2021.