Get a firsthand look at clinical data on preterm birth in pregnant women with rheumatic disease & COVID-19 at ACR Convergence 2022.
Preterm birth and low birth weight are more prevalent in patients with some types of rheumatic and musculoskeletal diseases due to higher disease activity during pregnancy. And a new study aimed to take a look at the knowledge gaps clinicians have on the effect of COVID-19 infection and vaccination on outcomes for pregnant women with rheumatic diseases.
This study, to be presented at the American College of Rheumatology’s annual meeting, ACR Convergence 2022, found a greater number of preterm births in unvaccinated versus fully vaccinated pregnant patients with rheumatic disease and COVID-19.
Researchers reviewed data from 73 pregnant patients who were entered into the COVID-19 Global Rheumatology Alliance registry, an international case-reporting registry created at the beginning of the pandemic which contains data from March 2020 to February 2022. This registry was created to help guide medical care for patients who’ve had a rheumatic disease or immunosuppression and COVID-19.
Outcomes were divided into three categories based on the vaccination status of pregnant patients prior to their COVID-19 infection: those who received no vaccine were defined as unvaccinated, those who received one vaccine and were defined as either unvaccinated or partially vaccinated, and those who received two or more doses were defined as vaccinated.
In terms of the rheumatic conditions for these patients, lupus was the most common one among the 73 pregnant patients. 70 percent were in remission at the time of their COVID-19 infection and 4.1% reported severe disease activity.
When data was extracted from the registry, 24.7 percent of the pregnancies were ongoing, while 50 of 55 completed pregnancies resulted in live births. The rest ended in miscarriage, stillbirth, or termination for the patient’s health.
The results of the study showed the following:
- Among completed pregnancies, 29.5 percent of unvaccinated patients had preterm births, and 18.2 percent of vaccinated patients had preterm births
- 24 percent of live births for unvaccinated patients resulted in low birth weight and was the most frequent neonatal complication
- 14 percent of live births for unvaccinated patients led to small size for gestational age
Along with that, the study showed that unvaccinated patients had higher rates of miscarriage, stillbirth, termination, pre-eclampsia, and gestational diabetes.
“Studies in the general population have demonstrated dysfunction of the renin-angiotensin system driving increased rates of pre-eclampsia in pregnant women with COVID-19,” explained Dr. Sinead Maguire, a rheumatology fellow at the Toronto Western Hospital in Canada and the study’s lead author.
“Postpartum, placental fetal vascular malperfusion has also been noted on histology of women infected with COVID-19. It’s unknown if or how the COVID-19 vaccine interferes with these processes. But [given the study results], we encourage COVID-19 vaccination in pregnant women with rheumatic diseases.”
The COVID-19 Global Rheumatology Alliance registry will summarize results from this study and distribute them to patients with patient advocacy groups to encourage COVID-19 vaccination in rheumatology patients. And according to Dr. Maguire, these results can also be used in future statutes to capture the impact of COVID-19 vaccination on pregnancy outcomes in patients with rheumatic diseases.