Does COVID-19 increase miscarriage risk in pregnant women?

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MURRAY, Utah (ABC4 News) – As COVID-19 cases in pregnant women are surging, doctors at Intermountain Healthcare say they’re studying every case carefully to better understand how the virus affects childbirth.

In the spring, three symptomatic COVID-19 patients experienced miscarriages.

“We have additional cases of still birth that have happened, and so there’s still concern,” said Dr. Sean Esplin, Medical Director of Obstetrics at Intermountain Healthcare.

“But I can’t come out and say that this is causative. I can tell you that we’re seeing very specific changes in the placenta in some women that are exposed to COVID or that we think are COVID-related. But that’s not in every patient. So we’re still trying to figure out why this happens in some women, but it doesn’t happen in others,” added Dr. Esplin.

Here’s what we do know: According to Dr. Esplin, 1 in 10 pregnant women treated had COVID-19 in November. So far, in December, that number has doubled.

“That’s a huge jump,” said Dr. Esplin.

One risk, he says, is that pregnant women might confuse COVID-19 symptoms with the more traditional symptoms experienced during pregnancy.

“People can have it and actually be pretty sick and not know it,” said Dr. Esplin.

“They can be unaware how short of breath they actually are, how low their oxygen levels are. During pregnancy, it’s really important to keep those oxygen levels high because if mom’s oxygen is low, then the baby is even lower,” added Dr. Esplin.

Another issue is blood clots. Dr. Esplin says those with coronavirus are at higher risk for blood clots; so too are pregnant women. That’s why medication is now used to prevent blood clots in pregnant women.

Brittany Garza found out she was COVID-19 positive at 36 weeks.

“It’s a scary time to be pregnant,” said Garza, as she held her 6-day old baby in her arms during a Zoom interview with ABC4 News.

Garza says she had to inject herself twice daily with blood clot medication from home. Doctors also performed an extra ultrasound in the weeks before the due date and more closely monitored the unborn baby’s heart rate, due to COVID-19.

“Some women are just having a really hard time with it, and some — it’s not affecting them as much,” said Garza.

“So I think everyone’s just nervous,” she added.

At Intermountain Healthcare, Dr. Esplin says they’ve learned so much since this Spring — especially since Utah’s rise in cases came later than in other states. Doctors here, he says, benefited from the real-time stories and evidence coming from hospitals elsewhere.

Research, he says, continues at Intermountain Healthcare and across the world, and with vaccines coming soon he says there is reason for optimism.

Still, he says — COVID-19 is a real threat to anybody, including pregnant women, and his best advice to expectant mothers is to follow CDC guidelines around mask wearing, social gathering and hand hygiene.

“Although the virus doesn’t cross the placenta, and get to the baby, it can get to the interface between the placenta and the lining of the uterus, where it can cause some changes in the blood vessels that changes how much oxygen and food and fluid are getting to the baby across the placenta. So it can kind of show up and make it so that the placenta doesn’t really work as well in some women,” said Dr. Esplin.

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