The impact of COVID-19 in pregnancy

Impact of COVID-19 in pregnancy graphic

Pregnant women around the globe have faced uncertainty with COVID-19. The Medical Research Council (MRC) has funded several studies to investigate the potential impacts of COVID-19 at all stages of pregnancy.

In December 2021 the Joint Committee on Vaccination and Immunisation (JCVI) advised that pregnant women are more at risk of severe COVID-19 disease. COVID-19 vaccination is now strongly recommended for pregnant and breastfeeding women.

Scientists have identified ‘significant knowledge gaps’ in the impact of COVID-19 on mothers’ and babies’ health at all stages of pregnancy.

Knowing more about the impact of the virus on pregnancy is vital for treatment and prevention: the SARS and MERS outbreaks resulted in over 25% case fatality in pregnant women, with worse effects for those infected earlier in their pregnancy.

The JCVI has now advised that pregnant women are more at risk of severe COVID-19 disease.

Pregnant women around the world have faced increased uncertainty with the arrival of COVID-19, the disease caused by the novel SARS-CoV-2 coronavirus.

Creating a global registry

Professor Christoph Lees and Dr Ed Mullins from Imperial College are leading a study co-funded by the MRC and the National Institute for Health Research to answer key questions about the impact of COVID-19 on pregnancy outcomes.

Dr Mullins said:

Key questions about pregnancy during the pandemic are whether the SARS-CoV-2 virus is associated with miscarriage, stillbirth and pre-term labour. We are also unclear if the virus gets transmitted from mothers to babies.

This study will rapidly collect information on women in pregnancy and their babies affected by the virus from around the world.

Through regular online updates and collaboration with other studies, we will improve our collective understanding of the infection in pregnancy and learn how we can lessen its impact.

They are investigating the effects of the SARS-CoV-2 virus in early pregnancy, the impact on foetal growth, prematurity and virus transmission to the baby, in collaboration with colleagues at Cardiff University and the International Society of Ultrasound in Obstetrics and Gynecology.

The team is building a registry of women with suspected and confirmed COVID-19, from early pregnancy to after the delivery of the baby. Healthcare professionals from the UK, Europe, China and the USA will contribute anonymised data via a web portal.

The psychological and social impact of COVID-19

Since March 2020, the COVID-19 Social Study has been conducting surveys and interviews to find out the psychological and social impact of the pandemic.

The study is led by researchers at University College London (UCL). It is supported by UK Research and Innovation, with further funding from the Wellcome Trust and the Nuffield Foundation.

More than 70,000 people have contributed:

  • 1 million surveys
  • 20,000 testimonials
  • 350 telephone interviews.

The COVID-19 Social Study has provided vital data throughout the pandemic. It shares its weekly results with key decision makers including:

  • the UK government
  • NHS England
  • the World Health Organisation
  • Public Health England.

Real-time analysis

The COVID-19 Social Study publishes weekly and monthly reports, which are all available to read.

The study now has the UK’s largest dataset on the topic.

The goal is to:

  • track patterns of mental health and loneliness in the UK throughout the pandemic
  • understand which groups are most at risk
  • identify proactive activities for people to mitigate the negative effects of the pandemic.

Week-by-week findings

The COVID-19 Social Study’s weekly reports change focus each week to track attitudes and behaviours and tackle emerging concerns. The study also publishes a monthly newsletter which summarises key findings from the previous weeks.

Findings include:

July 2020: As lockdown eased across the UK, depression and anxiety levels dropped. However, they plateaued and remained worse for people living alone and with lower household income.

November 2020: Only 51% of adults in England report understanding lockdown and social distancing rules. Only 13% of people say they fully understand the rules.

December 2020: Women reported higher levels of depression, anxiety and loneliness and lower levels of happiness than men. Women were also more worried about catching or becoming ill from the virus.

January 2021: Following the introduction of stricter rules in December 2020, life satisfaction decreased. It was markedly lower among people with an existing mental health condition.

March 2021: Quality of sleep deteriorated by 39% from March 2020. The number of people reporting ‘very poor’ sleep doubled from autumn 2020 to 10% in early 2021.

June 2021: By June 2021, people were less worried than ever about catching and falling ill with COVID-19. Just 21% of people were worried about catching COVID-19.

November 2021: Those who were struggling financially before the pandemic are more than twice as likely to say they are financially worse off than those living comfortably.

One year on

The COVID-19 Social Study continues to collect data and report on the psychological and social impacts of the pandemic.

Health and wellbeing of pregnant women and new parents

Led by Dr Josie Dickerson, the Born in Bradford team at Bradford Teaching Hospital Foundation Trust is working to find out how the changes in healthcare and social distancing in the pandemic have impacted the health and wellbeing of women and their partners:

  • during pregnancy
  • at birth
  • in the first year after having a baby.

Born in Bradford is a long-term cohort study and the only research programme in the UK that is currently recruiting into two birth cohorts:

  • Born in Bradford’s Better Start (BiBBS), which focuses on women living in ethnically diverse and deprived communities
  • BiB4All, a routine data linkage birth cohort study aiming to recruit all pregnant women booked to give birth at Bradford Teaching Hospitals NHS Foundation Trust.

This infrastructure will allow the team to recruit 1,800 pregnant women and their partners over the coming year and follow up throughout the perinatal period.

Dr Dickerson and her team will use a mixed-method approach of large-scale surveys and in-depth qualitative research to understand new parents’ experiences and concerns related to COVID-19, and their ability to access the health and social support they need.

They will also look at the impact of the pandemic on food, housing and income security, and self-reported physical and mental health.

Dr Dickerson said:

The NHS has identified pregnant women as high risk during the COVID-19 crisis. The additional stress alongside poor or fragmented care and social support may have profound effects on the health and wellbeing of women, their babies and their partners.

This research will inform practitioners, service providers and policymakers where intervention is needed to reduce these adverse effects in the short term, and as part of recovery.

Rapid analysis in combination with routine primary care, maternity, health visiting social care and education data will help provide timely information on areas where action is needed. Longer-term follow-up analysis will be of major scientific and policy significance.

The MRC has now committed almost £3 million of funding to Born in Bradford’s second wave, which runs from 2016 to 2021.

Baby boom or baby bust?

Birth rates were falling across the UK before the pandemic, but COVID-19 could lead to historically low levels.

Researchers won’t know the true impact of the pandemic on fertility rates until more data becomes available.

In the meantime, Professor Ann Berrington is using previous findings on how economic shocks affect society to create ‘what if’ scenarios for childbearing.

She’s building on trends identified as part of the ESRC Fertility Trends project and the ESRC Centre for Population Change.

Berrington said:

Our examination of some of the potential mechanisms through which the pandemic could affect childbearing suggests that recent declines in fertility rates could well be accelerated by the COVID-19 pandemic.

Read the findings in the ESRC Centre for Population Change Working Paper 95 ‘Recent trends in UK fertility and potential impacts of the COVID-19 pandemic.’

Last updated: 12 January 2022

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