Current evidence from the UK suggests that pregnant women are no more likely to get COVID-19 than other healthy adults, but if they are unvaccinated or not fully vaccinated, they are at increased risk of becoming severely unwell if they catch COVID-19, which can lead to admission to intensive care and premature birth of the baby.
From UK (UKOSS) and international registry data, we know that mothers who are at high risk of pregnancy complications ie – those with additional risk factors are at a higher risk of the complications of COVID in pregnancy. These include women aged over 35, with BMI over 30 or higher, with preexisting medical problems such as raised blood pressure (hypertension), asthma or diabetes and women of non-white ethnicity. A UK based study on admissions with COVID, nearly 98% of women who were admitted in intensive care were unvaccinated and nearly 80% of those admitted with symptoms of COVID were in third trimester.
In pregnant women with symptoms of COVID-19, it is twice as likely that their baby will be born early, exposing the baby to the risk of prematurity. Several international studies have also found that pregnant women who tested positive for COVID-19 at the time of birth were more likely to develop pre-eclampsia, more likely to need an emergency caesarean and their risk of stillbirth was twice as high, although the actual number of stillbirths remains low.
There are no separate data on women with twins and triplets and risks of COVID. However many mothers with twins and triplet pregnancies have risk factors (as above) that puts them at a higher risk of complications due to COVID in pregnancy. In addition, the chance of premature labour is higher in twins and triplet / higher order multiple pregnancy. It can therefore be extrapolated that mothers with twins or triplet pregnancies who become unwell with COVID would have a higher chance of preterm delivery and its subsequent complications.
It is however worth mentioning that roughly two-thirds of pregnant women with COVID-19 have no symptoms at all (also known as being asymptomatic). Most pregnant women who do have symptoms only have mild cold or flu-like symptoms.