Miscarriages in India tripled from 1st Covid wave to 2nd, Delta could be reason: ICMR study

New Delhi, September 30 (KMS): Miscarriages tripled during the second Covid wave in India, and India’s Delta variant could have been the reason behind more foetal deaths, according to a small study conducted in Mumbai by the Indian Council of Medical Research (ICMR).

The study uses the term ‘spontaneous abortions’ for miscarriages, meaning the loss of a pregnancy before 20 weeks of gestation or a foetus born weighing less than 500 grams.

Earlier research from ICMR’s National Institute for Research in Reproductive Health had shown that the second wave of the Covid pandemic led to an increase in maternal deaths, compared to the first wave. However, the impact of the second wave on spontaneous abortions had not been researched.

For this study, published Monday in Ultrasound in Obstetrics & Gynecology, the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, the team looked at 1,630 Covid-positive women who had suffered from spontaneous abortions at the B.Y.L. Nair Charitable Hospital in Mumbai from 1 April 2020 to 4 July 2021.

According to the researchers, the rate of spontaneous abortion was as high as 82.6 for every 1,000 births in the second wave, compared to 26.7 in the first wave.

The study noted that before the pandemic, spontaneous abortions were more common between February and July, compared to the August to January period. In 2021, the second wave lasted between February and July, meaning that such abortions were significantly higher in these months compared to the corresponding months in 2017 and 2018.

Delta variant

The researchers said the increase in spontaneous abortions during the second wave could be due to the presence of the highly infectious and virulent Delta variant of the coronavirus. The SARS-CoV-2 can infect the placenta and potentially affect fetal growth as well, they said.

Moreover, with higher Covid case rates and travel restrictions, there was a decrease in pregnant women’s access to care visits and nutritious food – factors that could have also led to increased spontaneous abortions.

One of the limits of the study, however, is that the researchers were unable to conduct SARS-CoV-2 tests on the foetuses. The team was also unable to conduct genome sequencing to identify the SARS-CoV-2 strains.

The study findings indicate that women who become pregnant during the pandemic need to be counselled about the risks, especially those who get infected with the disease during their first trimester of pregnancy.

“Our findings are crucial for public health policy, especially on prioritising the vaccination of pregnant women in India and other low-income and middle-income countries in light of the predicted third wave of Covid-19 pandemic,” the team wrote in the study.

Previous research has also shown that Covid has had detrimental effects on pregnant women, especially in low- and middle-income countries.

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