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Pandemic affects pregnant women health whether they catch Covid or not

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A new study, published in the medical journal Placenta co-authored by University of Manchester scientists, warns that even if they do not contract COVID, pandemic stress can leave a health impact on expectant mums.

A multinational study of 115 mothers who gave birth during the pandemic found considerably more physical anomalies in the placenta (the baby’s support system in the womb) than experts would expect to detect in pregnancy before 2020. Rates of placenta issues tripled among Covid-19-positive moms but doubled even among those who tested negative, implying that these alterations are caused by both the pandemic’s stress and the virus itself.

Stress during pregnancy can cause inflammation and functional abnormalities in the placenta, which can increase pregnancy risks and have long-term effects on baby development. Because Covid-19 causes inflammation, expecting mothers who contract the virus are worried that it would harm their placenta – yet, while being classified as a greater risk in the pandemic to safeguard their physical health, their emotional well-being is more readily disregarded.

Although past research have looked into how Covid-19 infection impacts pregnancy, this is the first to look at pandemic-related stress in mothers who do not have the virus. According to research, mothers who gave birth during the pandemic are more likely to suffer from clinical depression and anxiety, and a poll of 5,500 expectant and new parents in the UK indicated that 9 out of 10 felt more worried as a result of Covid-19. While some were sequestered in lockdown, others suffered the stress of being unable to avoid risky surroundings; over half of pregnant women did not feel secure going to work, and one in ten were (or were anticipated to be) laid off.

Professor Alexander Heazell, Director of Tommy’s Stillbirth Research Centre at the University of Manchester and study co-author, stated:

“The increase of placental problems we’ve seen during the pandemic is concerning, but we need more long-term research to understand the full effects of Covid-19 and related stresses on pregnancy; both clearly affect the placenta, but we still can’t tell exactly what that means for the health of mothers and babies. In the meantime, there must be appropriate psychological care and support available throughout pregnancy, to help reduce the pandemic’s impact on maternal wellbeing.”

Prof Heazell and his team at Tommy’s research centre took samples from the placenta, umbilical cord and fetal membranes of mums who gave birth at Saint Mary’s Hospital in Manchester from March to September 2020; study authors in Canada and France also took samples for analysis from their local hospitals. When an expectant mother tested positive for Covid-19, researchers randomly selected someone without the virus who gave birth in the same hospital at the same time, as well as comparing these groups with historic patient data.

More than three-quarters of mums with Covid-19 had abnormalities in their placentas (92.9% in the UK / 80.6% in Canada / 87.5% in France) compared to half of those who gave birth during the pandemic without having the virus (45.5% in the UK / 52.6% in Canada) and a quarter of the pre-2020 group (25% in Canada, consistent with other large studies).

Trends varied across countries, but common issues found in the UK were excess of a blood-clotting protein called fibrin (which can restrict babies’ growth) and calcification (calcium in the placenta builds up in late pregnancy to prepare for birth, but too much too soon can cause dangerous deterioration). Some abnormalities were only found in mums who had Covid-19, suggesting they’re caused by infection – but others happened across 2020 pregnancies and not in the control group, implying links to the stress of the pandemic rather than the virus itself. “

“The increase of placental problems we’ve seen during the pandemic is concerning, but we need more long-term research to understand the full effects of Covid-19 and related stresses on pregnancy; both clearly affect the placenta, but we still can’t tell exactly what that means for the health of mothers and babies. In the meantime, there must be appropriate psychological care and support available throughout pregnancy, to help reduce the pandemic’s impact on maternal wellbeing,” said Professor Alexander Heazell.

Researchers concluded that both Covid-19 and pandemic-related stress can affect the placenta, but more long-term studies are needed to properly assess the pandemic’s impact on the health of mothers and babies. Tommy’s CEO Jane Brewin said: “Good research evidence takes time, and the pandemic is still unfolding – so while our scientists keep working to understand how this affects pregnancy health, it’s vital that mums-to-be are supported mentally as well as physically. We’ve seen a huge rise in calls to the midwives on our helpline throughout the last 18 months, as the pandemic has created extra confusion and anxiety for many families along the pregnancy journey. Services are adapting but they’re still running, so mums shouldn’t hesitate to raise any concerns with their care team and seek help when needed.”

30-year-old content marketer Rachel from Rhyl found out she was expecting her first child just before the Government deemed pregnant women a higher risk group in the pandemic, which she describes as “extremely anxiety-inducing”. Rachel recalled: “I didn’t know what to do because I’ve never been through this before – and even if I had, Covid changed everything. I couldn’t just go to my midwife, and in fact I hardly saw any professionals until I was close to giving birth. I didn’t want to be a burden with my concerns when the NHS was in crisis, so I must’ve spoken to Tommy’s midwives on their helpline dozens of times; it really made such a difference to have a professional reassuring me that my anxieties weren’t unreasonable and giving advice to improve my mental wellbeing. Connecting with fellow mums-to-be online helped too, and I got to a place where my stress and anxiety levels were manageable.”

Tommy’s midwife Amina Hatia advised: “Any pregnancy can be stressful, and anxiety is a normal response to a threatening situation, so it’s completely understandable to struggle in times like these – but there are things expectant parents can do to feel more in control. We’re all different so the only advice that will apply to everyone is to focus on your physical and mental health, distracting yourself with things you enjoy or find relaxing, instead of being drawn into ‘what ifs’. Try to avoid the constant news cycle, which can be overwhelming, and only get updates from reliable sources when you need information. Talk to someone you’re close to, or release emotions into a journal, but don’t keep things in. Take it a day at a time, be kind to yourself, and reach out for support if you need it.”

Image Credit: Getty

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