There have been more pregnant women sick with COVID-19 in Ontario’s intensive care units in April than at any point in the pandemic, according to obstetricians who are calling on the provincial government to prioritize expectant mothers for vaccination.
Provincial data shows there were 13 pregnant women in provincial ICUs in the first 13 months of the pandemic.
Since April 1, obstetricians who spoke to the Star say they count at least 20 pregnant women who have received critical care or are currently in ICUs in hospitals in Greater Toronto, Hamilton, Niagara and Ottawa.
At Toronto’s Mount Sinai Hospital alone, 13 pregnant people have received ICU care this month, said Dr. Wendy Whittle, the hospital’s head of labour and delivery.
“It’s striking to walk into an intensive care unit and see a 26-year-old woman, who has no other medical problems, and who is 25 weeks pregnant, with a breathing tube … That’s shocking,” she said.
Dr. Jon Barrett, chair of the department of obstetrics and gynecology at Hamilton’s McMaster University, said pregnant people need to be considered high-risk in this third wave and prioritized for COVID-19 vaccines.
“We are all seeing pregnant people with COVID-19 coming into hospital with no other risk factors, and getting really sick, really quickly,” he said.
“At our hospital, we’ve had five pregnant patients this month needing intensive care, some needing urgent Caesarean sections. With pregnant people, there are two patients — the mother and the baby — to worry about.”
The alarming increase in the number of pregnant women with COVID-19 needing hospital care suggests expectant mothers may be more vulnerable to the variants of concern as compared to the original SARS-CoV-2 virus seen in the first and second waves, said Whittle.
The rise in cases may also be due to more community spread affecting younger patients of reproductive age, she said.
“In the first two waves, we had five pregnant people in total hospitalized in the ICU,” Whittle said, noting Sinai is a tertiary referral centre for high-risk pregnancies. “We have five pregnant people right now admitted to the ICU.”
Last week, the Society of Obstetricians and Gynecologists of Canada called on all provinces to “immediately prioritize vaccination for pregnant women.”
In a statement dated April 15, the SOGC said all pregnant people in Canada “should be eligible to receive the COVID-19 vaccine,” a call echoed by the obstetricians who spoke with the Star.
Currently, pregnant women are included in Phase 2 of Ontario’s vaccine rollout, among “individuals with at-risk health conditions,” according to the Ministry of Health.
On Tuesday, New Brunswick’s Department of Health confirmed all pregnant women in the province are now eligible for the COVID-19 vaccine, a move based on the recent SOGC recommendation.
In a statement to the Star, a spokesperson for Ontario’s Ministry of Health said they are aware of “reports of the increased risk COVID-19 presents to pregnant women during the third wave and are actively looking into this.”
The ministry spokesperson added they are in consultations with the province’s clinical advisory subgroup about “formally amending the guidelines for pregnant women to receive vaccinations.”
Dr. Arthur Zaltz, chief of obstetrics and gynecology at Sunnybrook Health Sciences Centre, said many of his pregnant patients want the COVID-19 vaccine and are frustrated that they do not qualify unless they are prioritized by neighbourhood or by profession.
“The conversations I am having now with my patients are not: ‘Should I?’ But ‘How can I?’ ‘Where can I go?’ ‘Can you do something to expedite this?’” he said.
“We certainly think that pregnant women should be considered at high risk and should be vaccinated. There’s a lot of that advocacy work going on to move them up the priority list.”
Deshayne Fell, a scientist at the CHEO Research Institute, said the uptick in pregnant patients needing hospital care is concerning and researchers are tracking the trend.
Data collected by the BORN Network shows there were 13 pregnant people with COVID-19 in provincial ICUs between March 2020 and the end of March 2021, she said, noting province-wide data for April will be released next month.
“The concern with pregnant individuals is that it’s not just one patient, but at least two, who are at risk,” said Fell.