Scientific research conducted by Brazilian professionals revealed that pregnant women who contract COVID-19 are at high risk of developing pre-eclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to another organ system. This usually occurs after 20 weeks of pregnancy in women whose blood pressure had been normal.
The work was published in early August in the journal Clinical Science. The study observes the analysis of a large set of data, with which it was concluded that the existence of the SARS-Cov-2 virus in the maternal system produces alterations in the levels of the angiotensin 2 (ACE2).
ACE2 is a protein with which the coronavirus mixes in order to invade cells and as a consequence generate a malfunction of the systems that depend on this protein that regulates blood pressure.
This protid has other very important functions such as serving in the establishment of blood flow in the placenta and in the cardiovascular adaptations that occur during pregnancy.
“Based on the results of the studies carried out to date on infection by SARS-CoV-2 in pregnant women and the role of ACE2 in the placenta, it can be concluded that pregnant women are at higher risk of developing the severe form of COVID-19 than non-pregnant women “, observed the first author of the article Nayara Azinheira Nobrega Cruz, doctor of the School of Medicine of the Federal University of São Paulo (Brazil).
In addition, he assured that mortality is higher among pregnant women with the disease. Infected pregnant women, according to Nobrega Cruz, are more susceptible to suffering pre-eclampsia and premature delivery.
Likewise, the researchers discovered that, although ACE2 is abundant in the placenta, the appearance of a severe version of COVID-19 in pregnant women is due to the inhibition of the action of the enzyme by the viral infection, since this reduces the possible resources of the protein and therefore, its protection capacity.
“A deficit of ACE2 can cause an imbalance in the renin-angiotensin system and an increase in the peptide angiotensin 2, a vasoconstrictor that raises the mother’s blood pressure and leads to pre-eclampsia,” said those responsible for the study.
They also highlighted “that the maternal mortality rate from COVID-19 was low (<1%); However, compared to pregnant women without COVID-19, the disease increased the chances of maternal death. In another large cohort from the United States that included more than 40,000 pregnancies and 6,380 with COVID-19, the rates of in-hospital deaths, myocardial infarction, and venous thromboembolism were higher in pregnancies with COVID-19. “
Thus, the probabilities of preeclampsia (1.21 with 95% CI 1.11-1.33) and preterm delivery (1.17 with 95% CI 1.06-1.29) were much higher in pregnancies with coronavirus than in those without it.
The authors added that there are disparities in mortality rates between countries, which they considered to be due to factors such as the high prevalence of hypertensive disorders, pre-eclampsia and obesity, as well as socioeconomic problems and deficiencies in the health system.