Experts work to understand COVID pregnancies
During the third wave of the COVID-19 pandemic last spring, Ontario hospitals began admitting growing numbers of very ill pregnant women. Ottawa obstetrician and researcher Dr. Darine ElChaar was among the physicians treating some of those patients.
“It was really hard to see patients in the ICU,” she said, especially patients who had to be intubated in order to breathe and couldn't have their families with them.
“It is not easy to see your patients who you can't talk to.”
Researchers know that COVID-19 hits pregnant women particularly hard: They are 11 times more likely than non-pregnant people of similar ages and health to require intensive care, according to data from CanCOVID-Preg Research based at the University of British Columbia. Pregnant women with COVID-19 are also at higher risk for preterm birth, according to Canadian and international research.
El-Chaar, a maternal-fetal medicine physician at The Ottawa Hospital and a researcher at The Ottawa Hospital Research Institute, leads a team of researchers working to better understand COVID-19 in pregnancy. The work, funded by the Canadian Institutes of Health Research, should inform future pandemics.
She is beginning new research looking at the impact of COVID -19 vaccination on pregnant women and their babies.
Since last summer, El-Chaar's team has been studying pregnant women who have been infected with COVID -19 to understand the impact on their babies and how it affects mothers. That work is continuing and El-Chaar hopes that researchers can follow the babies of mothers who were infected with COVID-19 for up to five years.
When they began the research, El-Chaar said, they expected no more than 50 women to take part. A year later, they have recruited 300 participants, 60 per cent of whom joined the study after becoming infected during the third wave. The team stopped recruiting last month, when the funding ended.
The research team is now analyzing the data.
El-Chaar has a tougher task ahead now — recruiting unvaccinated pregnant women for the second study on the impact of vaccines on mothers and babies.
The new research is aimed at better understanding the impact of COVID-19 vaccination during pregnancy on the immune system of pregnant individuals and their newborns. Researchers will measure immune responses in vaccinated participants and their babies and document vaccine-related reactions and health outcomes that may occur after vaccination.
The study will address questions including whether pregnant and non-pregnant people have different immune responses to the COVID -19 vaccine. It will also look at whether women can pass on protective antibodies to their babies.
Finding individuals who are not fully vaccinated is crucial to the research because it allows for baseline testing to determine whether the participants have existing antibodies from a previous infection.
COVID -19 vaccination is recommended during pregnancy because it protects against severe illness. Physicians were among those who pressed the province to prioritize pregnant women for second doses of vaccines last spring as severe cases among pregnant women increased during the third wave.
Pregnant women still have lower vaccination rates than the general population for a variety of reasons, which might make it easier to find recruits for the study, ElChaar said. Participants can get fully vaccinated as soon as initial data is collected, she said. So far, the research team has recruited 25 out of 100 anticipated participants.
El-Chaar said it had been frustrating to be unable to begin the research earlier. But she said it was important that research be done in Canada because each country has handled the pandemic differently, which adds to the domestic and global knowledge base.
The researchers hope real-time evidence from the study will “inform vaccine guidelines, support patient counselling by health care providers, encourage vaccine confidence and empower decision-making by families,” the research institute said in a statement.