At the end of April, Denise J. Jamieson, M.D., a member of the Covid-19 task force at the American College of Obstetricians and Gynecologists and chairwoman of gynecology and obstetrics at the Emory University School of Medicine, noted in an email that it was “remarkable” how much we still do not know about Covid-19 in pregnancy. “Even basic questions, such as whether or not pregnant women are more severely affected by Covid-19, remain unanswered,” she said at the time. Now it’s July, and little has changed.
This year, 483 Emory physicians made the “Top Doctors’” list out of 1,002 doctors named in the publication. That means Emory doctors make-up 48 percent of the doctors recognized in the issue, more than any other health system in metro Atlanta.
Pregnant women present particularly vexing issues. The new data, reported in CDC’s Morbidity and Mortality Weekly Report, compared more than 90,000 women with confirmed cases of COVID-19 who were between 15 and 44. The study has several important limitations, but in an age-adjusted analysis, the 8200 women who were pregnant had a 1.5 times higher risk of being admitted to an intensive care unit and a 1.7 times higher risk of requiring mechanical ventilation. “That is fairly compelling evidence” pregnant women should be prioritized for a vaccine, though their risk isn’t pronounced as the elderly,” says Denise Jamieson, an obstetrician/gynecologist at Emory University who is not an ACIP member.
Despite the ambiguities, some experts said the new data suggests at the very least that pregnant women with the coronavirus should be carefully monitored. If many of the pregnant women were hospitalized for labor and delivery, the proportion of women who were hospitalized for only coronavirus infection and became severely ill — those advancing to the I.C.U. or ventilation — would be even higher, said Dr. Denise Jamieson, a member of the Covid-19 task force at the American College of Obstetricians and Gynecologists. “I think the bottom line is this: These findings suggest that compared to nonpregnant women, pregnant women are more likely to have severe Covid,” she said.
The number of newborns has been falling for more than 10 years. And some experts say the coronavirus pandemic and its effect on the economy will result in even fewer births. “This unpredictable environment, and concerns about the future, are going to make women think twice before having children,” said Denise Jamieson. She is a doctor and head of the Department of Gynecology and Obstetrics at Emory University in Atlanta, Georgia.
Dr. Jennifer Kawwass has received the ACOG 2020 Mentor of the Year. She was nominated by Dr. Tess Kim, a former Emory University School of Medicine student (now a resident at Beth Israel). The award is given on behalf of the American College of Obstetricians and Gynecologists and the Junior Fellow College Advisory Council recognizes the contributions and commitment to mentorship to young ACOG members.
