Pregnancy complications spiked during early months of pandemic: Study

The COVID-19 pandemic caused more women to suffer serious health issues during their pregnancies than previously known, according to a new study.  

The COVID-19 pandemic and the state and federal responses to mitigate the spread of the virus have had major consequences for maternal health, most notably on the country’s maternal mortality rate.  

Between 2019 and 2021 the U.S. maternal mortality rate jumped from about 20 deaths per 100,000 live births to nearly 33 per 100,000 live births, according to the Centers for Disease Control and Prevention.

Scientists are still trying to figure out just how far-reaching the pandemic’s impact on maternal health has been. The study, published Wednesday in the journal Epidemiology, shows a connection between the pandemic and an increase in rates of gestational diabetes, hypertensive disorders and gestational weight gain among pregnant women.  

Researchers at the Harvard T.H. Chan School of Public Health used National Center for Health Statistics data on all live births between 2015 and 2021 to spot trends in maternal health.  

Researchers found that the rates of some pregnancy complications increased during the first two years of the COVID-19 pandemic.  

More pregnant women suffered from gestational diabetes in 2020 and 2021 than in the years before the virus reached the United States. The overall increase in gestational diabetes during the COVID-19 pandemic peaked at a 1.7 percentage point increase in December 2020, according to the study.  

Meanwhile, hypertensive disorders such as preeclampsia peaked at a 1.3 percentage point increase in January 2021 while an uptick in gestational weight gain peaked in March 2021, the study also shows.  

The study focuses on trends in maternal health and doesn’t attempt to identify a cause for the pregnancy complications many women experienced during the early days of the pandemic.  

But researchers do have some theories on the drivers behind these increases. For example, the rise in hypertensive disorders could be linked to COVID-19 infections.  

“We noticed that there was a specific uptick right around the Delta wave of the pandemic,” said Rita Hamad, director of social policies for health equity research at the Harvard T.H. Chan School of Public Health and co-author of the study. “We saw a huge surge and then it just kind of dropped back off.”  

A large spike in COVID-19 cases occurred in the U.S. over the winter months of 2020 and 2021 followed by a surge in the virus’s Delta variant starting in July of that year.  

Meanwhile, rates of gestational diabetes and gestational weight gain grew more gradually, suggesting their rise was due to limited access to exercise and, sometimes, healthy food due to pandemic-era lockdowns or orders to work from home.  

Stress during the COVID-19 pandemic is also something that likely contributed to the rise in these conditions, Hamad said.  

Researchers did notice a positive trend during part of the COVID-19 pandemic — more pregnant women received adequate prenatal care.  

For a period, researchers saw a decline in “inadequate prenatal care,” which peaked in January of 2021, according to the study.  

“Our hypothesis ... was that there were expansions in telehealth during the beginning of the pandemic,” said Hamad. “That might have been a brief silver lining.”