Unvaccinated pregnant women falling seriously ill from COVID-19, Iowa doctors say

Dr. Kelly Ferroni of Tiffin was 26 weeks pregnant when she tested positive for COVID-19.

She began experiencing mild cold-like symptoms last October, before the vaccines were available. Then, a little more than a week into the infection, the situation took a turn for the worse.

“It was about day nine of symptoms that I couldn’t even talk on the phone or speak a complete sentence without coughing,” recalled Ferroni, an obstetrician gynecologist at the University of Iowa Hospitals and Clinics.

Ferroni was admitted to the hospital, where she spent a week receiving oxygen and other treatments including steroids and convalescent plasma. She recovered and gave birth to a healthy baby girl, Madeline, in February.

However, things could have been much different for Ferroni and her daughter. Pregnant and recently pregnant women are at higher risk for severe illness from COVID-19, experts say.

But even with the proven safety and efficacy of vaccines, some pregnant women continue to forgo the shots. As a result, health care providers in Iowa say they are seeing more pregnant women — who otherwise are young and healthy — become severely ill with the virus.

“We are unfortunately still seeing a high frequency of pregnant women admitted to the hospital with COVID-19, and the one factor they have in common is that they are not vaccinated,” Ferroni said.

As the highly contagious delta variant has surged in recent months, the state’s largest hospital has seen an uptick in pregnant patients with COVID-19, providers said. Six pregnant patients recently were admitted to UIHC’s intensive-care unit with COVID-19, officials said.

Most needed to be placed on a ventilator or on an ECMO device, which is the highest level of life-support machine at hospitals. An ECMO machine oxygenates a patient’s blood outside the body, allowing the lungs and heart to rest.

“It makes our staff anxious,” said Dr. Joel Kline, a pulmonologist at UIHC. “We’re not only responsible for one life, which we’re used to, but we’re responsible for two lives, and sometimes there’s a conflict between what’s good for the mom and what’s good for the baby.”

Federal public health officials issued strong guidance Wednesday urging pregnant women to get vaccinated against COVID-19 as more hospitals nationwide report this situation.

So far, more than 125,000 COVID-19 cases have been reported in pregnant Americans throughout the pandemic, according to new data from the federal Centers for Disease Control and Prevention. Of those, more than 22,000 were hospitalized and 161 have died. Twenty-one pregnant women died in August alone.

Approximately 97 percent of those hospitalized with COVID-19 while pregnant were unvaccinated, CDC data shows.

“CDC strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks,” the agency said in its latest guidance.

Only about 31 percent of pregnant women were fully vaccinated as of Sept. 18, CDC data shows. That rate is even lower among Black mothers, with just 15 percent fully vaccinated.

Iowa does not track statistics specifically about pregnancy and the coronavirus, but state leaders have urged Iowa women to get vaccinated as quickly as possible.

"If you are thinking of having a baby someday or now, there is currently no evidence that the COVID-19 vaccine causes fertility problems in men or women. If you're pregnant, getting the COVID-19 vaccine is safe for both you and your baby,“ Kelly Garcia, interim director of the Iowa Department of Public Health, said at a news conference, the Des Moines Register reported.

COVID-19 poses greater risk to pregnant patients

Pregnant women infected with COVID-19 are 15 times more likely to die than those who are not infected, according to a study published last month in JAMA Network Open.

“The risks for pregnant women or baby are substantially higher if they were to get a COVID-19 infection than it would be if they were to get the COVID-19 vaccines,” Ferroni said.

COVID-19 patients who are pregnant tend to be admitted to the hospital, as well as the intensive-care unit, earlier than other patients.

Even when a woman’s oxygen levels drop moderately — not to the stage where its necessarily dangerous for her — it can be significantly detrimental to fetal development, the UIHC’s Kline said. Doctors typically want a pregnant women’s oxygen levels to stay at 95 percent or above, whereas other patients still are safe if their oxygen reaches 88 percent.

If doctors still are unable to provide adequate oxygen levels to the mother — even with the use of life-support machines — Kline said they would decide whether to perform an emergency C-section.

The JAMA study found pregnant women with COVID-19 are 22 times more likely to have a preterm birth, which carries its own risks for mother and baby.

“You don't want your baby to be delivered preterm if you can avoid it,” Kline said.

Vaccines safe for pregnant and lactating women, experts say

It’s an understandable reaction for pregnant women to not want to do anything to harm their baby, Ferroni said, but they may be relying on misinformation being shared on social media and other platforms “about unproven negative effects of the vaccine.”

Many women have expressed concern about potential adverse effects of the vaccine, but most have been proven to be false, experts say. For example, there’s been no evidence to suggest the vaccines cause fertility problems.

Studies have shown the risk of miscarriage is the same in vaccinated women as it is in those who are unvaccinated.

Ferroni, who shares her experience with patients, encouraged women who are pregnant or planning to be pregnant to talk to their doctor about the vaccine.

“We know the COVID vaccine is safe and we know that it is effective and we know that it is safe for pregnancy,” Ferroni said.

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