More unvaccinated pregnant women with Covid-19 hospitalised in Singapore

Unvaccinated, pregnant women are more at risk of severe complications from Covid-19.
Unvaccinated, pregnant women are more at risk of severe complications from Covid-19.PHOTO: PEXELS

SINGAPORE - Increasingly more pregnant women who have not been vaccinated against Covid-19 but became infected with it are now hospitalised here.

Unvaccinated, pregnant women are more at risk of severe complications from Covid-19, and should get their vaccines as soon as possible, stressed local obstetricians and gynaecologists, as well as infectious diseases specialists on Saturday (Oct 16).

Doctors spoke about Covid-19 vaccination during pregnancy at a free webinar organised by the College of Clinician Scientists under the Academy of Medicine Singapore.

It was attended by about 200 people, including pregnant women and members of the public.

"The numbers of (pregnant patients) are rapidly rising. Just a couple of days ago, we received a message from the ministry that there were about 20 pregnant patients who are Covid-19 positive... Unfortunately, among those, only one or two were fully vaccinated," said Associate Professor Tan Lay Kok, head of the department of maternal and foetal medicine at KK Women's and Children's Hospital (KKH).

Associate Professor Zubair Amin, head and senior consultant at the neonatology department in the Khoo Teck Puat - National University Children's Medical Institute at the National University Hospital (NUH), added: "We have seen an increasing number of pregnant women coming to us almost on a daily basis."

From May to Sept 30, KKH saw more than 40 cases of pregnant women infected with Covid-19, a significant rise, compared with few cases during the same period last year, said Professor Tan Hak Koon, chairman of the hospital's obstetrics and gynaecology (O&G) division.

Prof Tan did not take part in the webinar.

Some hospitals told The Straits Times that more pregnant women have been coming forward to get vaccinated since local Covid-19 cases started climbing in August.

From mid-June to Sept 30, KKH vaccinated more than 1,000 of its pregnant and breastfeeding patients, including those planning to conceive, said Prof Tan.

"A higher uptake was observed from August to September. However, a large group of pregnant women remains unvaccinated," he said.

Senior consultant Citra Mattar from NUH O&G department's division of maternal foetal medicine has observed that 50 per cent to 60 per cent of the hospital's pregnant patients have been fully or partially vaccinated, with the take-up rate picking up since August.

"Pregnant women who are more motivated, like front-line workers, came to get their vaccines first in June. On top of the current surge, social restrictions (targeting the unvaccinated) may have encouraged more to take the vaccine," added Associate Professor Citra, who also moderated the webinar on Saturday.

For instance, unvaccinated people have not been allowed inside malls since Oct 13.

Pregnant and breastfeeding women have been able to register to receive Covid-19 vaccines under the national programme since June 4. The Ministry of Health (MOH) had said then that such women should discuss the risks and benefits of the vaccination with their doctors to make an informed decision.

Unvaccinated pregnant women are at higher risk of severe complications - and need intensive care and mechanical ventilation - if they contract the disease. Maternal death and a stillborn child are possibilities as well.

In a Facebook post on Sept 29, Health Minister Ong Ye Kung said that more than 85 per cent of pregnant women hospitalised with Covid-19 were not fully vaccinated. Among them, about 20 per cent needed oxygen supplementation, and another 10 per cent needed high dependency care or care in the intensive care unit (ICU).

To date, no pregnant woman who contracted Covid-19 but was vaccinated against it has needed oxygen therapy or was sent to the ICU, said Prof Tan Lay Kok.

The risks for those unvaccinated, especially at the later stages of pregnancy, include pneumonia, compromised lungs and placenta rupture.

During the webinar, many women asked at what stage of their pregnancy they should get vaccinated. The doctors urged them to get vaccinated as soon as possible, given the current wave of Covid-19 cases.

Dr Ho Xin Yi, associate consultant at KKH's O&G department, said: "Some women may choose to delay their vaccine until after the first 13 weeks of pregnancy, which is the crucial time period for the baby's development. However, the question is, are we in a low-risk (community) situation right now?"

Dr Ho also emphasised that there is no evidence showing that Covid-19 vaccines can harm the foetus or put the pregnancy at risk.

She cited a study on birth defects or disorders among babies born to mothers vaccinated against Covid-19 that showed a 2.2 per cent incidence, similar to 3 per cent among babies born before the pandemic.

In fact, Covid-19 vaccines can be beneficial to babies, with some studies showing that certain protective antibodies from mothers can be transferred to babies via the placenta or through breast milk, said Prof Amin.

A 30-year-old pregnant woman who declined to reveal her name told The Straits Times that she tested positive for Covid-19 in June this year, while she was in her second trimester. She was not inoculated at the time.

But she contracted the virus even though she had been mostly staying at home. Fortunately, her symptoms during the first week in hospital were mild: fever, muscle ache and sore throat. She had no symptoms during the following two weeks, but was kept in hospital for observation.

Now, pregnant and vaccinated Covid-19 patients with mild or no symptoms are discharged after six days in hospital, while unvaccinated patients with severe complications may need to be hospitalised for up to three weeks, said Prof Citra.

When asked about her views on vaccination now, the 30-year-old said: "Based on what happened to me and what I'm seeing now with the vulnerable and more pregnant women getting (Covid-19), vaccination is an added layer of protection."

Last weekend, she registered for the jab. She is now in the 37th week of her pregnancy. This will be her first child.

"In my antenatal class in NUH, most women have been vaccinated. So I was thinking, 'what am I waiting for?'," she said.