An article published in the BMJ by Allyah Abbas-Hanif, Neena Modi and myself discusses the long term implications of Covid-19 in pregnancy. Covid-19 in pregnancy increases the risk of severe complications for both mother and baby. The long term implications are unknown, but emerging signals warn of substantial public health threats. To counter high vaccine hesitancy in pregnancy we must end the default exclusion of pregnant women from the rigorous regulated drug development process and implement systematic, long term, population-wide surveillance of infected and non-infected people.
The numbers of pregnant and postpartum women in the UK admitted to hospital or intensive care because of Covid-19 peaked over the summer of 2021 Maternal mortality has reached concerning levels in 2021, with case fatality rates rising in the US, doubling in Brazil, and almost tripling in India since the beginning of the pandemic. In Brazil, health officials even suggested avoiding pregnancy to reduce risk during the pandemic.
Inconsistent messaging from authorities, driven by lack of trial data, has increased Covid-19 vaccine hesitancy among pregnant women. This, coupled with the increased transmissibility of new variants and relaxing of social distancing restrictions, contributed to the surge in hospital admissions seen in successive waves. Concerns around the longer term effect of Covid-19 post partum, including long Covid, cardiovascular complications of covid-19, and widening socioeconomic disparities are also mounting. Despite a desperate need for treatments, pregnant women continue to be left behind.