BOISE, Idaho — Idaho doctors say they're seeing alarming trends tied to COVID-19 cases in pregnant women, including maternal deaths, increased incidence of stillbirths and neonatal intensive care unit patients that are sicker than usual.
In a news conference Wednesday, several Treasure Valley doctors specializing in pediatrics and neonatal care echoed what other Idaho health care providers have shared in recent days: Idaho's most recent COVID-19 surge is taking a toll on infants and pregnant women.
Officials said they've seen a spike in COVID-related pregnancy complications, as well as an increased need to deliver babies prematurely as pregnant women become incredibly sick with the disease.
Dr. Stacy Seyb, who works at St. Luke's Magic Valley as a specialist in high-risk pregnancies, told the Idaho Statesman in a video interview that his team is seeing an increase in "very sick moms, both during the pregnancy as well as after."
Seyb said that pregnant women are considered high risk for COVID-19 and are about five times as likely to be hospitalized as non-pregnant women the same age. He said there have been as many as five pregnant COVID-19 patients hospitalized at any time in recent weeks, and two pregnant women in the ICU with COVID-19 most of the time.
"I've never seen anything like it in my life," Seyb said. "For us as obstetricians ... the last two months I've learned more about COVID than in the last (year) because there's so many more patients."
Seyb said a positive diagnosis in a mother complicates things. He said moderate to severe cases occur primarily, if not exclusively, in women who haven't been vaccinated. Even in mild cases, it means additional precautions are necessary during delivery. Seyb said the hospital recommends that mom and baby be separated after birth to avoid the possibility of the infant contracting COVID-19.
"That's a tough thing to ask a mom to do," he said.
Seyb noted at least one instance in which a COVID-19-positive mother died. He declined to comment further on the case, saying only that the baby is doing "fine."
During Wednesday's news conference, St. Luke's Perinatal Health Director Dr. Lauren Miller echoed Seyb's experience, saying Idaho health care providers have witnessed "losses of moms" with COVID-19. Citing "the relative rarity of these cases" and privacy law, Miller declined to give details beyond stating that the women who died were "severely ill with specific COVID complications, requiring ... significant respiratory support."
The Idaho Statesman has reached out to the Idaho Department of Health and Welfare to try to determine how many pregnant women have died of COVID-19 over the duration of the pandemic.
Miller said she was not aware of any cases in which neither the mother nor the baby survived.
In another case, Seyb said, a pregnant COVID-19 patient "went into spontaneous labor" in the ICU.
"Her baby was too early to survive," Seyb said. "My colleague who was around that night said ... the ICU staff was just crushed."
Babies of COVID-19-positive women appear to have unique risks. Seyb said his team has also delivered "a number" of premature babies as their mothers fight moderate to severe COVID-19. He also reported an uptick in stillbirths among women who contracted COVID-19 while pregnant. That's a phenomenon that has been noted elsewhere in the U.S., though researchers have not yet determined a clear link between COVID-19 infection and stillbirth.
Miller on Wednesday said she, too, is seeing COVID-19-related stillbirths.
"I have personally seen several cases here in the last couple of weeks that had no other ... cause for their stillbirth other than their proximity to having a significant COVID infection, and that is very scary," Miller said.
Miller also cited recent research published in the Journal of the American Medical Association that suggests that infants are more at risk of contracting COVID-19 from their mothers while in utero than previously thought.
"That is also scary for our littlest of babies, especially when they're being born prematurely already because of how sick the mom is," she said.
Babies born prematurely are at risk for a number of short-term and long-term health risks, according to the Mayo Clinic. Dr. Nikolai Shalygin, a neonatologist with Mountain State Neonatology and Saint Alphonsus' NICU, told reporters Wednesday that NICU patients born to COVID-19-positive mothers appear to be sicker than patients the same gestational age whose mothers did not have COVID-19.
Shalygin said one baby born prematurely had a serious pneumothorax, or collapsed lung. Other infants are showing increased symptoms of respiratory disease and inflammation-related issues. Shalygin said in many cases, the babies are dealing with medical issues related to being born premature — circumstances that likely could've been avoided if their mothers hadn't gotten seriously ill with COVID-19.
Miller said St. Luke's staff have been "begging and pleading" with pregnant patients to be vaccinated against COVID-19.
"Everything that we have as far as data points to very good safety information for vaccination during pregnancy as well as postpartum and during lactation," she said.
The FDA has approved vaccines for pregnant and lactating individuals, and the Centers for Disease Control and Prevention has clarified that vaccines are safe for anyone planning to conceive in the future.
Seyb said multiple medical associations focused on maternal or neonatal health — including the Society for Maternal Fetal Medicine and the American College of Obstetricians and Gynecologists — have urged pregnant women to receive the COVID-19 vaccine.
"(There is) a lot of data to make us feel comfortable using it in pregnancy," Seyb said. "So you balance that with how sick we're seeing people who are not vaccinated, and that's the reason that we highly recommend it."
