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More States Seeing Uptick of Pregnant COVID Patients in ICUs

— Nearly all are unvaccinated, sources say

MedpageToday
A pregnant woman wearing an oxygen mask in the ICU.

A report from the University of Alabama at Birmingham (UAB) in August revealed that there had been a sharp increase in the number of pregnant patients who were being hospitalized with COVID-19. Nearly a month later, physicians from other states have started to voice similar concerns about the growing number of unvaccinated pregnant patients who have been admitted to ICUs with severe infection.

Mississippi state health officials on September 9 that eight pregnant women had died from COVID-19 in recent weeks; their babies were all delivered prematurely and survived, said state medical officer Thomas Dobbs, MD, MPH, during a press conference.

"Currently we are investigating eight reports of pregnant women who have died within the past several weeks, all of whom are unvaccinated," Dobbs added, according to the Sun Herald.

The state has also seen a devastating twofold increase in the rate of fetal deaths during COVID-19. Since the beginning of the pandemic, there have been 73 fetal deaths in Mississippi.

"We do know that COVID is especially problematic and dangerous in pregnant women, but we also know it can be deadly for the baby in the womb," Dobbs said. "With COVID, we have seen a doubling ... of fetal demise for the death of the baby in the womb after 20 weeks. It's been a real tragedy."

In Illinois, cities like and are also seeing more ICU admissions for pregnant COVID patients. Michael Leonardi, MD, an ob-gyn who specializes in high-risk pregnancies at OSF HealthCare in Peoria, told ľֱ that, starting roughly 6 weeks ago, pregnant COVID patients have been admitted to OSF with growing frequency.

"We've not had a fully vaccinated patient in the ICU," Leonardi said. "I've had several patients who have been discharged home, still pregnant, and we've convinced them to get vaccinated 2 weeks after their acute infection -- but it's unfortunate that that's what it takes to get somebody to get vaccinated."

By calling attention to this trend now, Leonardi hopes that more pregnant women will complete their vaccination series in order to prevent COVID-related deaths, like those seen in Alabama and Mississippi.

"Our numbers are not gigantic like they are in the Southeast," he said. "In a perverse sort of way, it's an impediment to getting people vaccinated ... Human nature for some people is to say, 'well, if it gets as bad as Alabama or Texas or Mississippi, then I'll get vaccinated.'"

Leonardi noted that approximately three out of four pregnant patients he has seen in his general practice have said they have not yet been vaccinated.

For Jeanne Steinbronn Sheffield, MD, the director of maternal-fetal medicine at Johns Hopkins, the number is one out of every two patients.

"We are also just starting to see an increase again in the number of COVID patients that are pregnant being admitted to ICUs. I've got one in right now," Sheffield told ľֱ. "All of them [are] unvaccinated. So we, like everybody else, are seeing the exact same trend."

Both Sheffield and Leonardi understand why so many mothers are hesitant to get the shots; beyond the widespread misinformation campaigns that circulate on social media, expecting mothers are first and foremost concerned about the health of their unborn children.

"It's an incredibly vulnerable time and women are willing to embrace putting their own health at risk in deference to trying to protect their fetus," Leonardi said.

He noted that, in some cases, other healthcare professionals may be guilty of adding to the already significant amount of vaccine misinformation. Several patients he has seen at OSF have said that an ob-gyn practice in the area had informed them that "anecdotally, they think more women are miscarrying who have been vaccinated."

He recalled a recent conversation with a NICU worker who was in tears after experiencing a miscarriage.

"Her obstetricians led her to believe she may have contributed to that by getting vaccinated. And she literally told me, 'I feel like I have PTSD and I can't go back to that practice,'" Leonardi said. "The person who's talking to you in the exam room is a powerful voice. And it can be a voice for good, or it can plant doubts in your mind."

The most shows that there is no increased risk of miscarriage or spontaneous abortion after COVID-19 vaccination. And when faced with understandably vaccine-hesitant patients, both Leonardi and Sheffield broach the topic by offering the wealth of peer-reviewed data that show the vaccines' safety and benefits to expecting mothers. Sometimes, this approach works to get through to patients.

"I can't tie them down and force them to get the vaccine," Sheffield said. "But I hope with all the data that's out there and a discussion about that data, that they'll accept it."

On whether or not pregnant women should be prioritized to get a booster shot, both physicians agreed that -- until there is updated guidance from the CDC -- boosters should be currently recommended only to immunocompromised patients who would qualify regardless of their pregnancy status.

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    Kara Grant joined the Enterprise & Investigative Reporting team at ľֱ in February 2021. She covers psychiatry, mental health, and medical education.