PregCovid is a collaboration between ICMR-National Institute for Research in Reproductive Health (NIRRH), Medical Education and Drugs Department, Government of Maharashtra, city’s Nair hospital
Experts say the adverse impact of Covid on pregnant women is high as they have a lower immunity. Representation pic
An initiative by the Indian Council of Medical Research and state government to study maternal and child health issues in pregnant women who have suffered or are infected with Covid-19 has been hailed by experts. The study, PregCovid (National Registry of Pregnant Women with Covid 19 in India), aims at formulating strategies for effective management of Covid-19 during pregnancy.
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PregCovid is a collaboration between ICMR-National Institute for Research in Reproductive Health (NIRRH), Medical Education and Drugs Department, Government of Maharashtra, city’s Nair hospital.
“Any registry, data collection and documentation will help us anticipate immediate and long-term outcomes. It will also help us change our approach to treatment and guidelines. That’s what we have learnt from the first and second waves from other countries. As per available information from hospitals and colleagues, there is definitely an increase in Covid-19 infection and complications in pregnancy and neonates including deaths. This kind of registry , we should implement also in other chronic organ diseases and organ transplant patients,” said Dr Fazal Nabi, Director of Paediatric department, Jaslok hospital.
Welcoming the initiative, Dr Deepti Dogaonkar, ex-professor of obstetrics and gynaecologist, Grant Medical College, and ex-dean at GMC Nagpur, Latur and Miraj, said, “Why to collaborate only in Maharashtra, [they] should involve state capitals or all government medical colleges in India where reporting is reliable. Baseline Nair hospital study should be published to make a draft. I cannot believe the inability to access health care in a pandemic. Maternity beds are not given for Covid hospital. Ambulance 108 is available for Janani Suraksha Yojana, but not avialable when required the most for pregnant woman. Problems are in rural and taluka places for accessibility and reporting. Overall, there is a need to make it notifiable, strengthening diagnosis services during pregnancy.”
She said restriction of crowd near pregnant women and lactating mothers is a must. “Avoiding pregnancy in a pandemic, using contraception, is desirable. Vaccination between 4th to 7th months of pregnancy is recommended or 3 months after delivery. Remember what is more dangerous -- pregnancy or Covid? Lowered immunity during pregnancy makes Covid19 more infectious, more severe and more morbid. The study should continue for six months after delivery to know post Covid-19 effects,” said Dogaonkar, adding that the baby’s face should be covered for a month, especially while breast feeding after the mother and new born return from hospital. Also there should be restrictions on family members visiting nursing mothers. The mother should wear mask round the clock, even while at home and before breast feeding, she must wash her hands,with regular soap, and should avoid using hand santizers.”
When asked the reason for same, Dr Dogaonkar explained, “Most hand sanitizers contain alcohol, and babies are sensitive to the same, and the baby may not have the feed, due to the foul smell of such hand sanitizers.”.
Dr Wiqar Shaikh, Professor of Medicine, Grant Medical College and Sir J.J. Group of Hospitals, cited an article in JAMA Paediatrics published in April 2021 that said pregnant women who contract Covid-19 are 50 per cent more likely to have complications like premature deliveries, abortions, birth defects in their children and high blood pressure and may indeed need critical care. Also, such women need more oxygen support.
As per a report dated June 16 by US Centre for Disease Control, Dr Shaikh said, only 10 per cent of pregnant women in the age group of 25 to 49 years received vaccines in America, whereas only 3.1 per cent in the age group of 18 to 24 years were vaccinated. Pregnant women affected by the virus have an increased risk of death due to lower immunity.
Dr Shaikh said, “This data would be of paramount importance because 5 per cent of the Indian population comprises pregnant women,” he said.
According to Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle, an estimated 3 per cent of India’s annual pregnancy rate of over 35 million would have had Covid during the two waves and over 30,000 had some adverse pregnancy outcome.
“Extrapolating from a meta-analysis of 42 Covid-19 pregnancy studies comprising 4.4 lakh women published in PMC open access journal in April 2021, it is established that Covid-19 was responsible for 2-4 times maternal deaths, preeclampsia, gestational diabetes, preterm and/or low birth weight, abortion or stillbirth. Compared with mild Covid-19 that had adverse outcomes at twice the normal rate, severe Covid-19 was strongly associated with four times the rate of adverse outcomes,” he added.
Dr Hira, who was on the advisory committee of NIRRH, said, “There are ongoing studies in the US and Europe to determine safety and efficacy of vaccines in pregnant women. So far, it’s all safe and effective for mother-child pairs. My guess would be that NIRRH will include nasal or mucosal vaccines while following the pregnant women as their Covid-19 episode gets settled.”
PregCovid Registry
The study focuses on
>> Socio-demographic, clinical presentations and reproductive traits of pregnant and post-partum women with Covid
>> Determining pregnancy and fetal outcomes and the effects of treatment
>> Evaluating proportion of maternal to fetal transmission of Covid
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