Med J Aust 2022; 217 (5): . || doi: 10.5694/mja2.51683
Published online: 5 September 2022

Coronavirus disease 2019 (COVID‐19) infection in pregnant women is associated with increased risk of adverse outcomes compared with women who are not pregnant, according to a review published in JACC: Advances . Cardiovascular complications include heart attack, arrythmias, heart failure and long‐haul symptoms that may be difficult to distinguish from other cardiac complications of pregnancy and require the cardiovascular care team to be vigilant when assessing pregnant women with COVID‐19. The Centers for Disease Control and Prevention (CDC) found pregnant women are at increased risk of adverse outcomes with COVID‐19, including severe infection (10%), intensive care unit admission (4%), mechanical ventilation (3%), and use of extracorporeal membrane oxygenation haemodynamic support (0.2%), compared with non‐pregnant women of reproductive age. Additionally, pregnant patients who were of increased maternal age, high body mass index or had other pre‐existing conditions, such as chronic hypertension, pre‐eclampsia and pre‐existing diabetes, were at even higher risk for severe infection. When compared with pregnant women without COVID‐19, pregnant patients with COVID‐19 were at higher risk for pre‐term birth and stillbirth. Overall, 33% of infants born to patients with COVID‐19 were admitted to the neonatal intensive care unit. No other differences have been found for perinatal outcomes. According to the authors, a reason for increased risk of cardiovascular complications is the low vaccination rate in pregnant women compared with other groups. In a recent study of over 130 000 pregnant people, over three‐quarters of those requiring hospital admission, most patients requiring critical care, and all fetal deaths occurred in unvaccinated compared with vaccinated women. The authors suggest management of cardiac complications in pregnant patients with COVID‐19 requires the creation of a “pregnancy heart team” to optimise care, which may include providers comfortable with high risk pregnancy, obstetric anaesthesia, cardiology, critical care and neonatal care, depending on the nature of the complication, stage of pregnancy and severity of infection.



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