Pregnant women make up ‘disproportionate’ number of Covid-19 hospitalisations

Pregnant women make up a "disproportionate" number of those hospitalised with Covid-19 and in intensive care in recent weeks, a senior Health Service Executive (HSE) official has said.

Dr Peter McKenna, HSE clinical director of women and infants health, said the current Delta variant was "more aggressive" when it came to affecting pregnant women.

“A few weeks ago when we had numbers in intensive care in their teens, a disproportionate [number] of these were pregnant women,” Dr McKenna told RTÉ radio’s Morning Ireland.

“The current variant of the virus, the Delta variant, is more aggressive when it comes to dealing with pregnant women,” he said.

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The comments follow reports from hospitals in Belfast of an increasing number of pregnant women among those hospitalised for Covid-19.

“What’s happening in Northern Ireland is just a manifestation of what happens when the Delta variant runs rampant in a population that is unvaccinated,” Dr McKenna said.

At present there are 182 Covid-positive patients in hospitals in the Republic.

There are currently three patients, recorded as recently pregnant, in intensive care with Covid-19, according to internal figures from an ICU database.

Dr Michael Power, intensive care consultant in Beaumont Hospital, said at present four-fifths of Covid-19 patients in ICUs had not been vaccinated.

Hospitals were not seeing numbers of pregnant women with Covid-19 similar to high levels reported in Belfast in recent days, he said.

It was “understandable” that pregnant women might have concerns about receiving the vaccine. However, he said “the science is standing up now, vaccination does confer benefit and protection ... for mother and baby.”

“Critical illness for a pregnant woman at any stage is a problem,” he said.

The Belfast Trust has said in the past week it has treated 12 pregnant women for Covid-19.

The trust, which runs several Belfast hospitals, cautioned that unvaccinated pregnant women were more likely to become unwell if they contracted the virus.

“Covid is affecting capacity issues because babies with the virus have to be isolated for 10 days after they are born,” the hospital group said in a statement.

“If pregnant women become unwell due to Covid, they are more likely to need admission to hospital and require additional respiratory [breathing],” the statement said.

“Pregnant women are having to be ventilated with the majority being hospitalised in their third trimester, over 26 weeks,” it said. “Pregnancy means an expectant mother’s lung capacity is already reduced, and Covid then further increases pressure on the lungs.”

Vaccine

A spokeswoman for the trust said it did not have a breakdown of the number of the 12 pregnant women who were vaccinated, or unvaccinated.

However, it is understood Belfast hospital officials are seeking to encourage pregnant women to receive the Covid-19 vaccine, due to the risks from the virus.

The Belfast Trust said it recently had to arrange preterm delivery for a number of pregnant women with Covid-19, after which the babies were admitted to the neonatal intensive care unit.

“If a baby is in the neonatal unit and its parents are Covid positive, unfortunately, for infection prevention and control reasons, parents will not be allowed to hold their baby until they have completed the required period of isolation or had a negative PCR test. Currently, six babies are in isolation,” the hospital group said.

The statement encouraged pregnant women worried about the safety of the Covid-19 vaccine to speak to their midwife, general practitioner or hospital consultant.

Maternity hospital restrictions

Separately, new HSE guidance was issued to maternity hospitals on Friday to allow partners of pregnant women accompany them at 12-week scans, and in the cases of caesarean sections.

Dr Colm Henry, HSE chief clinical officer, said the aim of the new guidance was to try to return to pre-pandemic visiting rights.

“It is very hard to unravel and pretend the pandemic isn’t there because of the risk the virus presents to unvaccinated pregnant women,” he cautioned.

Both Dr Henry and HSE chief executive Paul Reid spoke to the heads of hospital groups last Friday and received commitments that all maternity units were substantially in compliance with guidance on partner visits.

In a number of recent cases where partners were incorrectly denied entry to hospitals, they had received apologies, Mr Reid said on Thursday.

Health officials have said maternity hospitals would have to provide explanations for situations where guidance on visits for partners was not followed.

In some cases, where a hospital might be dealing with a Covid-19 outbreak, limits on partners accompanying pregnant women may still be put in place.