Mumbai: Experts welcome ICMR-led study of Covid-19 effect on pregnancy

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 Covid19 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 Covid19 during pregnancyPregCovid is a collaboration between ICMRNational Institute for Research in Reproductive Health NIRRH Medical Education and Drugs Department Government of Maharashtra cityrsquos Nair hospitalldquoAny registry data collection and documentation will help us anticipate immediate and longterm outcomes It will also help us change our approach to treatment and guidelines Thatrsquos 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 Covid19 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 patientsrdquo said Dr Fazal Nabi Director of Paediatric department Jaslok hospitalWelcoming the initiative Dr Deepti Dogaonkar exprofessor of obstetrics and gynaecologist Grant Medical College and exdean at GMC Nagpur Latur and Miraj said ldquoWhy 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 pregnancyrdquoShe said restriction of crowd near pregnant women and lactating mothers is a must ldquoAvoiding 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 Covid19 effectsrdquo said Dogaonkar adding that the babyrsquos 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 handswith regular soap and should avoid using hand santizersrdquoWhen asked the reason for same Dr Dogaonkar explained ldquoMost 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 sanitizersrdquoDr Wiqar Shaikh Professor of Medicine Grant Medical College and Sir JJ Group of Hospitals cited an article in JAMA Paediatrics published in April 2021 that said pregnant women who contract Covid19 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 supportAs 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 31 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 immunityDr Shaikh said ldquoThis data would be of paramount importance because 5 per cent of the Indian population comprises pregnant womenrdquo he saidAccording to Dr Subhash Hira Professor of Global Health at the University of WashingtonSeattle an estimated 3 per cent of Indiarsquos annual pregnancy rate of over 35 million would have had Covid during the two waves and over 30000 had some adverse pregnancy outcomeldquoExtrapolating from a metaanalysis of 42 Covid19 pregnancy studies comprising 44 lakh women published in PMC open access journal in April 2021 it is established that Covid19 was responsible for 24 times maternal deaths preeclampsia gestational diabetes preterm andor low birth weight abortion or stillbirth Compared with mild Covid19 that had adverse outcomes at twice the normal rate severe Covid19 was strongly associated with four times the rate of adverse outcomesrdquo he addedDr Hira who was on the advisory committee of NIRRH said ldquoThere are ongoing studies in the US and Europe to determine safety and efficacy of vaccines in pregnant women So far itrsquos all safe and effective for motherchild pairs My guess would be that NIRRH will include nasal or mucosal vaccines while following the pregnant women as their Covid19 episode gets settledrdquoPregCovid RegistryThe study focuses ongtgt Sociodemographic clinical presentations and reproductive traits of pregnant and postpartum women with Covidgtgt Determining pregnancy and fetal outcomes and the effects of treatmentgtgt Evaluating proportion of maternal to fetal transmission of Covid