88% Covid positive pregnant women asymptomatic: Study

The study -- 'Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India' -- has been accepted for publication in the European Journal of Obstetrics, Gynaecology and Reproductive Biology. (Representational Image)

A new study, conducted among over 1,140 pregnant women in the state, has found that 88 per cent Covid positive pregnant women were asymptomatic and has strongly recommended the strategy of universal testing.

The study — ‘Universal screening identifies asymptomatic carriers of SARS-CoV-2 among pregnant women in India’ — has been accepted for publication in the European Journal of Obstetrics, Gynaecology and Reproductive Biology. It was conducted by the State Medical Education and Drugs Department, government of Maharashtra, and ICMR – National Institute for Research in Reproductive Health, along with other hospitals.

“Universal testing of pregnant women admitted for delivery must be implemented rigorously, not just to protect the women and their newborns but also healthcare workers, and curb spread of the infection in the community,” Dr Sanjay Mukherjee, one of the key researchers and former secretary of the State Medical Education and Drugs Department, told The Indian Express.

Asymptomatic women with Covid-19 are at risk of infecting their newborns and also pose a risk to healthcare providers and other patients. Considering this, the Indian Council of Medical Research has recommended universal testing for SARS-CoV-2 in pregnant women. “Our joint collaborative study has estimated presence of one symptomatic to every nine asymptomatic pregnant women with Covid-19,” said Dr Smita Mahale, director of ICMR- National Institute of Research in Reproductive Health (NIRRH).

Maharashtra is the state worst hit by the pandemic in India, with over 12 lakh Covid-19 cases, and universal screening strategy for pregnant women has been implemented in several public hospitals.

Dr Rahul Gajbhiye, NIRRH scientist and co-researcher, said that women in labour or those likely to deliver soon were screened for SARS-CoV-2 as per ICMR guidelines, and data from April 25 to May 20 was collected from 15 participating hospitals of PregCovid registry network .

In all, 141 of 1,140 pregnant women tested positive for SARS-CoV-2, resulting in a prevalence of 12.3 per cent in Maharashtra. For estimation of numbers of symptomatic and asymptomatic pregnant women, the data of 141 women was pooled with data from Topiwala National Medical College and BYL Nair Hospital, which exclusively caters to Covid-19 patients. Of the 321 SARS-CoV-2 positive women, only 37 women were symptomatic. The prevalence of symptomatic pregnant women is 11.5 per cent while that of asymptomatic pregnant women is 88.5 per cent.

“This data on undocumented or ‘steady state’ infections in pregnant women is useful for ensuring safe obstetric and neonatal services and assessing the burden of Covid-19 in the region to plan strategies on strengthening or relaxing mass social distancing measures,” said Dr Mahale.

PregCovid registry network set up

A PregCovid registry network has been set up as a joint collaboration between ICMR-NIRRH and the state Medical Education and Drugs Department. Data about pregnant women who are Covid positive and their babies is recorded in the registry. So far, data of approximately 3,000 Covid positive pregnant women has been updated in the registry. While data is being analysed, researchers said that this registry will help provide information on various aspects of pregnancy in Covid positive woman, her child and what the outcomes are.

“Usually, new mothers are supported by their families during the pregnancy and after delivery. However, social isolation due to testing positive for Covid-19 also saw some cases being vulnerable to post-partum psychosis. Having co-morbid Covid-19 infection or the fact that these women had to deliver during the pandemic can itself put undue stress on them, leading to precipitation of psychiatric illnesses. We have reported three such cases of postpartum psychosis associated with asymptomatic Covid-19, which were managed at Topiwala National Medical College (TNMC) & BY L Nair Charitable Hospital in Mumbai,” said Dr Mahale.

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