Thread by @Protect_BC

TODAY: our informative live interview on the risks of Covid & Pregnancy.

Please join us at 12:30 pm for an hour with Dr. Genevieve Eastabrook. Free livestream is here: protectbc.ca/livestream/

We will livetweet the briefing here, so please follow along.
#bcpoli

https://twitter.com/Protect_BC/status/1663636319636197376

Welcome to our live tweeting session. We're so excited to be joined by Dr. Eastabrook today! She is a Maternal Fetal Medicine subspecialist & will talk about risks to pregnant people & fetuses. We'll wrap up with resources to protect yourself.

"Often times conditions are unmasked in pregnancy. People can be vulnerable during this time, especially to respiratory illnesses."

On incidence of still birth and miscarriage: First trimester miscarriage is reassuringly not as common. Odds ratio of having a still birth with Covid is 2.4 - so your risk is more than doubled. This is in unvaccinated population - so vaccination brings this down.

Q: Should we be putting patients on aspirin for example if they have Covid?

There isn't a lot of data suggesting evidence-based management. For those with POTS or new-onset hypertension post Covid, low dose ASA may help. Anecdotal.

Q: Does Covid cause an increased risk of gestational diabetes?

There isn't a lot of data or guidance, but it is a possibility.

Q: What about fetal growth restriction?

32-36 week ultrasound is being offered for those who have Covid during pregnancy to monitor this.

Q: What about Long Covid in pregnancy? New study showed up to 25% of those who have Covid during pregnancy could develop #LongCovid - risks could be increased

Now we're moving on to risks to the fetus - risks of increased neurodevelopmental disorders such as autism and ADHD needs to be monitored. Some data showing increased risks but there are confounders.

Children who survived 1918 pandemic & were ill in utero - it wasn't until 60 yrs later that they showed an increase in heart disease, diabetes, Parkinson's - scary thought!

Q: What are your thoughts about exposing pregnant patients to viruses such as RSV to help with immunity?

"I haven't really found any good evidence that's the case." RSV can be a significant infection in pregnancy.

Is Paxlovid safe in pregnancy? Yes, it is beneficial - Ontario doesn't have the access issues BC does. Pregnancy is a high-risk state.

Q: Are vaccines safe in pregnancy? Yes, safe in all trimesters in pregnancy. No safety signals. Boosting in 2nd & 3rd trimester may pass along some immunity to baby.

Q: What about masking in healthcare during pregnancy? "BC has a more anti-mask stance in healthcare" (the struggle is real...)

We encourage pregnant people to wear masks in high-risk situations. Healthcare providers should wear masks around pregnant people.

RESOURCE: @Protect_BC has a letter to help assist pregnant patients to request their medical providers to wear masks.

Patients should feel empowered asking HCW to mask.🙌

Q: Any last thoughts you'd like to share with us?

Covid during pregnancy is something to be cautious about, but we have tools. Therapies such as Paxlovid & Remdesivir, masks. Be cautious but optimistic.

Audience question: Do vaccines affect fertility? There has been no evidence that vaccination impairs fertility.

Re-cap: Any viral infection in pregnancy can be an increased risk due to increased cardiovascular output, changes to immune system, vascular changes, etc.

(You don't need to get sick to get well!)

Thanks so much Dr. Eastabrook! Fantastic session. Our next live briefing will be on June 29 on Covid & the Heart with @kasza_leslie