Maria Laura Avignolo
04/26/2021 13:01
Clarín.com
World
Updated 04/26/2021 1:01 PM
José Villar is an Argentine doctor, born in Rosario, professor of perinatal medicine at the
Oxford University and who led a huge study on the impact of the coronavirus on
pregnant women
.
"I think it should not be taken as an alarmist question," he immediately clarifies in an exclusive interview with Clarín.
But, he adds, "the infection considerably increases the risk of complications of the mother, of the pathologies of pregnancy, especially pre-eclampsia and of the newborn".
The study was carried out by 43 institutions in 18 countries, between March and October 2020. And it established the risk associated with Covid-19 in
mothers and babies
, compared to pregnant mothers who were not infected.
Dr. José Villar, an Argentine neonatologist, was the leader of the study conducted on women in Argentina, Brazil, Egypt, France, Ghana, India, Indonesia and Italy, among other countries.
-What were the main findings of this study?
-I believe that it should not be taken as an alarmist question, but rather as a reality that pregnant women, compared to pregnant women who are not infected, the infection considerably increases the risk of complications in the mother, of the pathologies of the pregnancy, especially preeclampsia and the newborn.
"At a time when in many places the capacity for intensive therapy is more or less at the limit, it must be taken into account that these patients are extremely serious"
José VillarProfessor of Perinatal Medicine at the University of Oxford
-What does this mean?
-It is a note of care that pregnant women represent a risk group due to the very fact of being pregnant and that they represent two people, the mother and the newborn, and that the complications are serious and therefore care should be taken.
Today vaccines are available and the authorities in different countries already recommend vaccination to pregnant women.
So I think we have made great progress this year.
-Was there a high level of mortality among mothers and newborns?
-Not in newborns.
Because the disease has practically very mild or no symptoms in newborns.
What we have found is that there are complications in the newborn, they are in intensive care and need special care.
-Why are they complicated?
-Because many of these mothers have respiratory complications, they are in intensive care, with pre-eclampsia.
And this motivates that the delivery must be produced previously given the complications of the mother and the fetus.
Therefore, it is through the increase in prematurity that complications begin in the newborn.
Pregnant women with covid can suffer from respiratory problems that force them to give birth prematurely.
Photo: Reuters.
-And the mothers?
-Pregnant women, especially in the last trimester, have an increased need for respiratory issues, oxygen, the burden of the fetus and this produces an increase in respiratory complications and also an increase in pregnancy complications.
And above all, what we have observed and documented well precisely is an increased risk of hypertension, pre-eclampsia, which is an important and severe disease of pregnancy, which in turn increases the chances of complications.
-What other data have caught your attention?
-We have seen, and it is a fact to take into account, a significant increase in admission to intensive care for pregnant women, compared to pregnant women who do not have Covid and also more days in intensive care, means a greater risk of having to be referred to another hospital and a significant increase in death. The actual mortality was low, but those who had Covid had a very large increase in mortality compared to pregnant women who did not. So at a time when in many places the capacity for intensive care or intensive care is more or less at the limit due to the normal development of the epidemic, it must be taken into account that these patients are extremely serious and require intensive care. important. So let's say the intensive care needs increase even further.
“The best vaccine is the one you can find and get vaccinated.
The best vaccine is the one you have on "
José VillarProfessor of Perinatal Medicine at the University of Oxford
-Why didn't you choose to do this study based on race as well? When blacks and Asians are apparently much more vulnerable to covid.
-Well, the truth is that we do not believe that there is any genetic difference that in any way increases the risk from a genetic point of view.
There may be regions in the world where for reasons of infection or for reasons of treatment offer or for multiple reasons, the risk of people living in those regions increases.
So we made the decision because there was no evidence and because it is important to try not to stigmatize that certain people have a certain risk if there is no concrete evidence, especially in a definition as broad as who belongs to what race.
New variants and vaccines
-The new variants such as the Manaus and the South African, do they operate differently on pregnancy?
-Well, that's a very interesting question.
The reality is that during the second wave of the epidemic in Europe, the same in Argentina that is now at the peak of the second wave, it has been found that the cases of complications during pregnancy are more severe than in the first wave.
So there are now many more severe cases of pregnant women than before.
That is a fact.
Now the reality is that it is not clear if this is because the variants of the virus, such as the Manaus variant or the English or South African variant, have an effect directly aggravating the picture.
Obviously these variants have an effect increasing contagion.
In other words, they are more contagious and faster.
Therefore there are more pregnant women infected with COVID today, compared to the first wave.
-Is one vaccine more recommended than another for pregnant women?
-I think the answer is no.
As they say, the best vaccine is the one you can find and get vaccinated.
The best vaccine is the one you have on.
Coincidentally last week, the UK Joint Committee on Vaccination and Immunization recommended that the vaccine should be offered to all pregnant women.
In other words, all leading institutions already advise vaccination in pregnant women.
-What was observed in the vaccinated pregnant women?
-What there is today is that the country that vaccinated the most pregnant women was the United States, where there are practically around 90,000 or 100,000 pregnant women vaccinated.
What is there today is that the country that vaccinated the most pregnant women was the United States, where there are practically around 90,000 to 100,000 pregnant women vaccinated.
What produces reinsurance for everyone is that there have been no complications of any kind.
-What vaccine did they receive?
-In the United States they were primarily vaccinated with messenger RNA vaccines and therefore the experience is with it.
But anyway, the other vaccines that have not been evaluated in a large population like this, there is no evidence or any reason to suspect that they have any side effects other than what is to be expected.
Therefore, answering your question more specifically.
Any of the vaccines helps reduce the biggest problem, which is being in intensive care or dying, which is already a very big advance in this disease.
Paris, correspondent
ap
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