Asia Pacific Initiative on Reproduction (ASPIRE) 2022 Congress
A global review of the effects of COVID-19 on pregnancy and the fetus has cast new light on the importance of improving the low uptake of coronavirus vaccination to protect pregnant women and their babies in the on-going pandemic.
Reproductive medicine specialists from more than 100 countries have been presented with mounting evidence that compared to pregnant women without COVID-19, child-bearing women with the disease face increased risk of admission to intensive care and possible death associated with complications of the virus.
There are also worrying research outcomes showing that the need for admission to neonatal intensive care is higher among babies born to mothers with SARS-CoV-2, the virus that causes COVID-19, compared to those without the condition.
Speaking at the 2022 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE), maternal fetal specialist Dr Liona Poon said pregnant women generally were at an increased risk of acquiring viral respiratory infection and developing severe pneumonia due to physiological changes in their immune and cardiopulmonary systems.
“After accounting for differences in baseline characteristics for severe COVID-19 between pregnant and non-pregnant women, pregnancy itself has emerged as a risk factor for pneumonia and possible death in SARS-CoV-2 infected women of reproductive age,” she said today.
“Other factors such as advanced maternal age, diabetes, hypertension, obesity, renal disease and asthma combined with social vulnerabilities and deprivation – including poor access to health care, housing and education – are also risk factors for COVID-19 related death.”
Dr Poon, Professor of Obstetrics and Gynaecology at the Chinese University of Hong Kong and a specialist in maternal fetal medicine, reviewed a range of global studies on the impacts of COVID-19 on pregnancy and perinatal outcomes.
She said initial research among COVID-19 hospitalised women in China did not raise serious alarm bells, but subsequent studies – including those in the United Kingdom, United States, and more recently in Mexico – had demonstrated a clear association between the SARS-CoV-2 infection and adverse outcomes among pregnant women and their offspring.
Dr Poon, who is also Visiting Professor in the Department of Women and Children’s Health at King’s College London, said there was a higher incidence of COVID-19 complications among pregnant women who were aged over 35, who were overweight or obese, and who were black or of other ethnic backgrounds.
She highlighted the COVID-19 crisis in Latin-American populations and high COVID-19 related mortality rates in countries such as Mexico.
The Mexican data showed that COVID-19 mortality among pregnant women was two times higher among those aged 40 to 44 compared to women 35 to 39.
Dr Poon said there had been many studies on the potential risk of mother-to-baby transmission of the SARS-CoV-2 virus, but that more research was required.
“We are working on new data that will take into account the Delta variant and the apparent reduced severity of the Omicron variant of the SARS-CoV-2 virus, but knowing that pregnancy is a major risk factor for severe COVID-19, it is vital for pregnant and lactating women to get vaccinated,” she said.
Speaking at the ASPIRE Congress on the Sheba experience of COVID-19 vaccines and fertility management, Professor Raoul Orvieto from the Sackler Faculty of Medicine at Tel-Aviv University, said Israel was one of the first countries that widely vaccinated its population against the virus.
In their studies, they were the first to report on the influence of COVID-19 infection and mRNA SARS-CoV-2 vaccine on the stimulation characteristics and embryological variables of patients undergoing IVF treatments.
Although both SARS-CoV-2 infection and mRNA SARS-CoV-2 vaccine did not affect patients’ performance or ovarian reserve in their immediate subsequent IVF cycle, SARS-CoV-2 infection was demonstrated to cause a significant reduction in the proportion of top quality embryos.
Professor Orvieto said they therefore recommended with caution to resume IVF treatment after three months of recovery. “Moreover, no effects of the mRNA SARS-CoV-2 vaccine were observed in patients’ AMH levels (a measure of ovarian reserve) or endometrial receptivity, nor on semen analysis,” he added.
He expressed concern about unfounded claims in some media outlets linking the COVID-19 vaccine with potential infertility.
“Such false claims by anti-vaccine activists aim to incite fear and deter public opinion from vaccination consequently jeopardising the vaccination plan and the end of the pandemic.
“Our results refute such claims and strengthen the notion that the SARS-CoV-2 vaccine is safe and should be recommended in fertility seeking couples,” Professor Orvieto added.
Interview:
Professor Liona Poon and Professor Raoul Orvieto are available for interview.
To arrange, please contact Trevor Gill, ASPIRE 2022 Congress Media Relations.
Tel: (Australia) 0418 821948 email: lighthousepr@adelaide.on.net