• Posted July 12, 2024

Nearly 1 in 10 Pregnant Women Who Get COVID Develop Long COVID

Almost 10% of women who get COVID during pregnancy develop long-lasting symptoms, and a new study suggests doctors may be overlooking them.

"I doubt most obstetric clinicians are as aware of Long COVID as perhaps we should be," said study co-leader Dr. Torri Metz, vice chair of obstetrics and gynecology at University of Utah Health.

"But people are having these symptoms, and we need to make sure that we're not forgetting that these could be long-term manifestations of their SARS-CoV-2 infection," Metz added in a university news release.

Previous studies had shown that COVID poses unique risks to pregnant women. For example, it increases the chances of preterm birth or stillbirth and is more likely to lead to hospitalization or death of the mother. But the risk for long COVID had not been researched.

For the study, Metz' team enrolled more than 1,500 women nationwide who got COVID for the first time during pregnancy. The women self-reported on symptoms at least six months after their initial infection. 

In all, researchers found that 9.3% of women who got COVID during pregnancy experienced long-term symptoms -- most often fatigue, gastrointestinal issues and feeling drained or exhausted by routine activities.

The study was part of a massive nationwide collaboration led by the National Institutes of Health to understand and treat Long COVID. Researchers said its size provided an accurate picture of risk across demographic groups.

"This is a critical study as pregnancy and the postpartum period are one of the most vulnerable times in an individual's life," said Dr. David Goff, division director for cardiovascular sciences at the NIH's National Heart, Lung, and Blood Institute. The NIH funded the study.

"By better understanding how individual characteristics interact with SARS-CoV-2 infection during pregnancy and lead to an increased risk of Long COVID, this study yields important insights to potentially develop targeted interventions for this population," Goff added.

To make sure that the Long COVID symptoms women reported weren't symptoms of pregnancy itself, the researchers did a separate analysis that included only people who reported symptoms more than 12 weeks after giving birth. 

The risk of Long COVID remained similar, confirming the initial findings. 

"Our results highlight that people who were pregnant when they got COVID may have significant long-term symptoms after pregnancy, like fatigue even after simple activities that they did before the infection," said senior study author Dr. Vanessa Jacoby, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. 

While researchers were surprised that the rate of long COVID was so high, Metz said the risk for pregnant women may actually be underestimated. That's because the study may have missed women whose symptoms resolved before women were asked to report whether they had Long COVID symptoms.

Those who were anxious or depressed before getting sick and those who were obese were more likely to have Long COVID symptoms, the study found. Financial hardship was also associated with higher rates of Long COVID, but researchers noted it wasn't clear whether money problems were a cause or consequence of the continuing symptoms.

The findings were published July 11 in the journal Obstetrics & Gynecology.

Previous studies of Long COVID in the general population have yielded a range of rates -- from 10% to more than 20% -- putting pregnant women at the lower end of the spectrum.

Metz said that might be because pregnant women's immune systems tend to respond less forcefully to infection. That puts them at higher risk of severe illness at the start, but may lower their risk of long-term organ damage that can lead to persistent symptoms, she said. Another possible explanation: Pregnant women tend to be younger and healthier than other populations.

"We need to have this on our radar as we're seeing patients," Metz said. "It's something we really don't want to miss. And we want to get people referred to appropriate specialists who treat Long COVID."

More information

The U.S. Centers for Disease Control and Prevention has more about Long COVID. 

SOURCE: University of Utah, news release, July 8, 2024