Stillbirth rate up in Mumbai in 2nd Covid wave: Study – Times of India

MUMBAI: There was a significant rise in the proportion of stillbirths, where a baby dies in the womb after over 20 weeks of pregnancy, during the second wave, a study by two city institutes has found.
The findings were based on a retrospective analysis of 1,645 pregnant women with Covid who were treated and delivered at B Y L Nair Hospital between April 2020 and July 2021. The stillbirth rate more than doubled during the second wave at 34.8 per 1,000 births against 14.6 during the first wave, it was found.
In absolute numbers, there were 12 stillbirths out of 807 deliveries during the first wave, and again 12 stillbirths from 335 deliveries during the second wave. Of the 24 women who had stillbirths, 41.7% were symptomatic.
‘Preeclampsia may’ve played a role in higher stillbirths’
Our study demonstrates evidence of an increase in the stillbirth rate during the second wave in India compared with the first wave and pre-pandemic period,” jointly wrote the authors from Nair Hospital and the Parel-based National Institute of Research in Reproductive Health (NIRRH) in the paper that was published in the European Journal of Obstetrics & Gynaecology and Reproductive Biology. They underlined that any global analyses to study the impact of coronavirus must include stillbirths.
Preeclampsia, a serious blood pressure condition in pregnant women, was higher in those with stillbirths during the second wave (25%) compared to the first wave
(8.3%), and is suspected to have contributed to the higher stillbirths. “The higher percentage of preeclampsia indirectly supports the theory that the infection predisposes pregnant women to a greater risk of developing preeclampsia due to its pro-inflammatory state,” the authors wrote. They have also hypothesised that the increased stillbirths could be associated with the Delta variant, but they couldn’t say with certainly due to the lack of genome sequencing data.
The BYL Nair hospital was converted into a dedicated Covid facility during the first wave after many smaller nursing homes and maternity facilities shut down fearing the infection. They treated 1,143 pregnant women in the first wave (April 2020 to January 2021) and 502 during the second wave study period (February to July 2021).
The study attributed onefourth of the stillbirths during the second wave to Covid as the patients had moderate to severe disease. During the first wave, none of the pregnant women in the hospital had serious symptoms. In the later wave, some had breathing difficulty by the time of admission, and a few were admitted with intrauterine foetal death.
The proportion of symptomatic women in the second wave (35.9%) was much higher than the first wave
(14.2%), wrote gynaecologist Dr Neeraj Mahajan, the lead author. Breathing discomfort among pregnant women was only observed during the second wave. Overall, during both the waves combined, 21% of the 1,645 pregnant women had one or more symptoms, while the rest were asymptomatic.
Co-author Dr Rahul Gajbhiye from NIRRH had previously told TOI that pregnant women should be encouraged to get vaccinated as several studies have now shown that they can suffer from severe outcomes. In Mumbai, less than 2,000 pregnant women of the estimated 1.5 lakh have got vaccinated till Monday.