When Alix Mellor fell ill with COVID, he went through the whole set of symptoms: coughing all night, high temperatures, and relentless physical fatigue.
But it was what she couldn’t feel that really made her worry. Days after the infection and 34 weeks pregnant, she noticed that her baby was unusually still.
“I called the midwives and they told me to come to the hospital and they did a fetal follow-up to make sure the baby was okay,” says the Melbourne mother. “I thought it wasn’t just me, it was the baby.”
It was the second time in three weeks that Melbourne’s mother was in hospital with a respiratory illness. The first was with a nasty flu attack that saw her hospitalized for four days with a “very high pulse.”
Women who test positive for COVID-19 while pregnant have a higher risk of hospitalization and ventilation than those who are not pregnant and also have a higher risk of preterm birth and death. It is a similar situation for the flu, which can be deadly for expectant mothers.
And now, as COVID cases are on the rise again with the arrival of the new Omicron BA.4 and BA.5 subvariants, and Australia is preparing for an intense flu season, women Pregnant women must decide whether to try to limit their contact with the outside world or run the risk of contracting the virus.
Alix Mellor contracted the flu and COVID a few weeks apart, while she was more than 30 weeks pregnant. (Supplied by: Alix Mellor)
Alix was well aware of her increased vulnerability and had been trying to take precautions to limit her exposure to the disease. He has also received three doses of COVID vaccine, tested positive just before being eligible for the fourth, which shows that research significantly reduces the risk of serious illness and pregnancy complications.
“I’ve managed to avoid COVID and the flu for the last few years, then of course, at the end of the pregnancy, I got it,” she says. “Congestion and coughing all night, when I’m already uncomfortable, it’s not fun.”
Fortunately, Alix’s unborn baby appears to be healthy, but two weeks since she tested positive for COVID, the 38-year-old has yet to fully recover.
And with a four-week countdown to the birth, she desperately expects her symptoms to go away sooner rather than later.
What we know about pregnancy and COVID
The link between COVID, pregnancy and an increased risk of complications has been evident since the beginning of the pandemic. This includes higher rates of premature births and deaths in women who test positive during pregnancy, as well as higher rates of hospitalization and ventilation.
“All sorts of bad things you don’t want to happen when you’re pregnant can happen if you put COVID into pregnancy in an unvaccinated population,” says Professor Caroline Homer, director of the maternity, childhood and adolescent co-program. health at the Burnet Institute.
Professor Caroline Homer urges pregnant women not to delay their COVID reinforcements.
There are a number of reasons why this is so. During pregnancy, the cardiovascular and respiratory systems already work overtime to support the fetus. Then, as the baby grows, the mother’s lung capacity shrinks even more as the fetus takes up more space in the body.
“You lose some of that lung expansion and you can’t breathe as much as you normally would,” says Professor Homer. “So when you have COVID and you have pneumonia or a lung infection, you can’t erase it so easily when you’re pregnant, especially in this last third of pregnancy.”
When there is an inflammatory response in the body, for example from COVID or other diseases, the body can also respond by entering partly early. High temperatures in the mother, especially in early pregnancy, have also been linked to later abnormalities.
“If the mother is sick, the baby is sick too, the baby’s oxygen levels depend entirely on those of the mothers,” says Lisa Hui, an associate professor of obstetrics and gynecology at the University of Melbourne.
“This is part of the reason why babies may have to be born prematurely; because they are compromised due to a maternal illness, but it is also possible that the mother may not be able to cope with her own illness and support the baby. same time “.
Vaccination benefits the mother and baby at birth
The good news, according to Professor Homer, is that vaccination contributes greatly to reducing the severe symptoms of COVID in the mother, which reduces the likelihood of harm to the unborn baby.
“Vaccination greatly reduces all risks, it probably doesn’t take it all out, but it makes a huge difference,” he says. “And it doesn’t seem to have any adverse effects on the baby or the mother.”
A recent Victorian study, led by Associate Professor Hui, looked at data from 12 Melbourne maternity hospitals between July 2021 and March this year and found no increase in birth defects or fetal growth restrictions in vaccinated pregnant women. .
The study, which has not yet been peer-reviewed, also found that vaccinated women had significantly lower premature and premature birth rates and a lower rate of COVID infection during pregnancy compared to their partners. not vaccinated.
According to the report, of the women who took COVID while they were pregnant, 2.3% of vaccinated women had a premature baby compared to 7% of unvaccinated women.
Associate Professor Hui attributes some of the findings to the biological effects of the vaccine, which reduces the risk of suffering from severe COVID disease associated with preterm birth and death, but says “it’s probably not the full story.”
“We know that one of the biggest influences on whether a pregnant woman decides to get vaccinated during pregnancy or not is the quality of the relationship she has with her maternity care provider … so women who not being vaccinated may actually be a group that is less committed to prenatal care or may feel marginalized, “he says.
“The results of our study have two important messages: one is that it gives us, as health professionals in the community, confidence that vaccination during pregnancy is safe, but it is also a message to the health system that we must strive. us more to look at.after women who have not been vaccinated “.
A study published in the New England Journal of Medicine last week has also shown that antibodies generated after vaccination during pregnancy can pass through the placenta into the baby, resulting in a reduction in hospitalization for COVID in infants under six months.
“This is a mechanism similar to what happens with flu vaccination during pregnancy, it causes an increase in the production of these antibodies by the mother, they cross the placenta and the baby is born with protection,” says the professor associate Hui.
“Now we have the data and everything is very quiet; getting vaccinated during pregnancy protects the mother, protects the baby from birth and protects the newborn.”
The double threat ‘flurona’
For now, Professor Homer says it is “quite uncommon” for pregnant women to be hospitalized by COVID. But there is another viral disease that poses an equal danger: the flu.
Alix was unlucky enough to catch both of them in short succession.
“It’s been six weeks without being very well,” he says. “I really can’t do much, it’s ruining the last part of the pregnancy.”
The combination of the COVID pandemic and a larger-than-usual flu season causes experts to be concerned about simultaneous flu and COVID infections, called “flurone”.
A dose of this Frankenstein’s disease would be especially dangerous for pregnant women, who are at higher risk of dying and suffering from serious flu-like illnesses.
The annual flu vaccine has been recommended for pregnant women over the past decade, and Professor Homer says it is especially important this year, as “we are seeing the flu in the community at very high levels.”
With people over 30 now able to access a fourth dose of COVID vaccine, it also urges all pregnant people to get it as soon as possible. “Pregnancy is not a reason to delay getting these booster doses,” she says, “because we know that having booster on board makes your symptoms much less so.”
Vaccinated or not, pregnant women who contract COVID should seek advice from their midwife or doctor. In many hospitals, this will activate a registration system where the mother receives additional follow-up during her illness.
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With the increase in COVID and flu cases, Associate Professor Hui also recommends using additional social distancing strategies and wearing a mask when this is not possible.
For Alix, her obstetrician’s advice has been to rest, drink plenty of fluids, take Panadol for fever, and “be patient.” “My immune system is already suppressed being pregnant, then having flu and COVID plus, it’s normal for me to be exhausted and take time,” she says.
But if at some point the baby stops moving, his heart rate increases, or he starts to feel really bad, he goes back to the hospital.
“I feel like I’ve done what I could, I can’t do much more than rest,” he says. “But preparing for childbirth is a marathon in itself, and I already have a daughter. I need to rest but it’s not easy.”
Space to play or pause, M to mute, left and right arrows to search, up and down arrows for volume. Clock duration: 4 minutes 29 seconds 4 m 29 s The risk of long COVID builds up with reinfection, says Norman Swan.
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