A large UK study on the outcomes of 427 pregnant women and their babies during the coronavirus (COVID-19) pandemic in the UK has been published today.
The results show that, between 1 March and 14 April 2020, 4.9 pregnant women per 1,000 were admitted to hospital in the UK with coronavirus and around 1 in 10 of whom received intensive care. This supports the RCOG and RCM clinical guidance that pregnant woman are at no greater risk of severe illness than the non-pregnant population.
The study found that 55% of pregnant women admitted to hospital with coronavirus were from a black, asian or other minority ethnic (BAME) background - 13% of the UK population identify themselves as BAME. Older pregnant women, those who were overweight or obese, and pregnant women with pre-existing conditions such as high blood pressure and diabetes were also more likely to be admitted to hospital. In total, five pregnant women with coronavirus sadly died during this period, but it is unclear at this stage if coronavirus was the cause of death.
The majority of women who did become severely ill were in their third trimester of pregnancy, emphasising the importance of social distancing for this group.
The UKOSS study is being conducted by the University of Oxford with input from key partners, such as the RCOG.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:
"Addressing health inequalities is a key strategic priority for the RCOG and we continue to urge the Government to tackle these across women’s health as a matter of urgency.
“There is a pressing need to record and analyse all coronavirus hospital admissions and deaths in detail, and to establish why this striking ethnic variation exists.
“We already know women from certain ethnic groups may be more likely to have pre-existing health conditions and complications, and socioeconomic inequalities impact on the accessibility of health services, and lead to poorer outcomes. We need to better understand these complex factors and how to make services fully accessible and inclusive so that no woman is left behind.
“We will continue to work closely with the Government, the Royal College of Midwives, the UKOSS study, and other key partners to continually review the latest evidence as it emerges and update our clinical guidance for pregnant women, and the health professionals who look after them, to ensure the very best care during this pandemic."
Royal College of Midwives’ Head of Quality and Safety, Zeenath Uddin, said:
“Clearly any maternal death is a tragedy. We owe it to these families to understand why this has happened and prevent other families from going through the same trauma. Alongside this, we need to ensure that there are no barriers to women seeking, and receiving, help and support during their pregnancy.
“While we may not yet know why, we know that expectant mothers from BAME backgrounds are more vulnerable to COVID-19 than the general population. It is why midwives are not only following up with those women who have missed appointments but also offering them additional appointments where necessary.”
Dr Christine Ekechi, Consultant Obstetrician and Gynaecologist, and spokesperson on racial equality for the RCOG, said:
“We are deeply saddened to learn of the five deaths in pregnant women and our heartfelt sympathies and thoughts are with their families during this very difficult time. The underlying causes of these deaths are currently unknown. We owe it to each woman, her family and wider society to find out why these deaths have occurred, and to prevent future tragedies wherever possible.
“It is of great concern that over half - 55% - of pregnant women admitted to hospital with coronavirus were from a BAME background, and this deepens our concerns around persisting vulnerabilities of this particular group of women.
“We are updating our guidance to reflect that BAME women should be told at each contact with a health professional that they may be at higher risk of complications of coronavirus, and advised to seek help early if they are concerned about their health.
“Healthcare professionals should be aware of this increased risk, and have a lower threshold to review, admit and consider multidisciplinary escalation in women of BAME background.
“Pregnant BAME women who develop more severe symptoms of coronavirus, or feel their recovery is delayed, may be developing more severe illness and need enhanced care. In these cases, they should contact NHS111, their maternity unit or, in an emergency 999.”
Shaista Gohir, RCOG Women’s Voices Lead, said:
"As we already know, widespread health inequalities impact the experience and outcomes of women, and this is simply unacceptable. At the RCOG, we will continue to ensure the voices of women and their families remain at the heart of improving healthcare services to be fully inclusive, to reduce health variations, and to make sure every woman receives the very best care, experience and outcome."
Notes to editors
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Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS). The paper is available on the University of Oxford website as a pre-print publication.
In response to this study, the RCOG national guidance on coronavirus infection in pregnancy and Q&As for pregnant women and their families will be updated shortly.
The RCOG is collaborating with the UK Obstetric Surveillance System (UKOSS) at the University of Oxford which is collecting information and data on cases of coronavirus in pregnancy to provide further information on outcomes. Also, Imperial College London have a surveillance programme (PAN-COVID) to monitor pregnancy and neonatal outcomes related to coronavirus.
In March 2020, the RCOG called on the Government to tackle racial inequalities in women’s health.
The RCOG launched a policy position statement calling for action on International Women’s Day 2020, calling for urgent action and highlights key areas to pursue.
In December 2019, the RCOG launched its landmark ‘Better for Women’ national report to improve the health of girls and women in the UK. Key findings and recommendations focus on how ethnicity, maternal age and social inequalities have a marked effect on pregnancy outcomes in the UK.
About the RCOG
The Royal College of Obstetricians and Gynaecologists (RCOG) is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. For more information, visit: www.rcog.org.uk
About the RCM
The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at www.rcm.org.uk