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Uterus

Pregnancy Complications Have Been Common During the Pandemic, Researchers Say

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More expectant women died, experienced complicated pregnancies or delivered stillborn babies during the pandemic than in previous years, according to an analysis of 40 studies in 17 countries published on Wednesday in the journal Lancet Global Health.

Pregnant women face a heightened risk of severe illness and death if infected with the coronavirus. But the researchers, in Turkey and the United Kingdom, wanted to assess collateral damage from the pandemic on pregnancies separately, and so excluded from their analysis studies that looked only at pregnant women who were infected.

Reviewing data on more than 6 million pregnancies, the investigators found that disruptions to health care systems and patients’ fear of becoming infected at clinics led to avoidable deaths of mothers and babies, especially in low- and middle-income countries.

Data from a dozen studies showed that the chances of a stillbirth increased by 28 percent. And the risk of women dying while pregnant or during childbirth increased by more than a third in two countries: Mexico and India. A subset of studies that assessed mental health showed that postpartum depression and anxiety were also heightened during the pandemic.

Nearly six times as many women needed surgery for ectopic pregnancies — in which a fertilized egg grows outside the uterus — during the pandemic than before. Ectopic pregnancies can be treated with medications if detected early, so the results suggest that the surgeries may have resulted from delays in care.

The analysis did not find differences in other conditions associated with pregnancy, like gestational diabetes or high blood pressure, or in the rates of cesarean sections or induced labor.

The rates of preterm birth also did not change significantly during the pandemic in low- and middle-income countries. But in high-income countries, preterm births fell by nearly 10 percent.

The drop may be a result of changes in health care delivery and in pregnant women’s behavior during the pandemic, the researchers said, indicating that the pandemic has exacerbated disparities between low- and high-income countries.

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Scientists Grow Mice Embryos in a Mechanical Womb

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The mouse embryos looked perfectly normal. All their organs were developing as expected, along with their limbs and circulatory and nervous systems. Their tiny hearts were beating at a normal 170 beats per minute.

But these embryos were not growing in a mother mouse. They were developed inside an artificial uterus, the first time such a feat has been accomplished, scientists reported on Wednesday.

The experiments, at the Weizmann Institute of Science in Israel, were meant to help scientists understand how mammals develop and how gene mutations, nutrients and environmental conditions may affect the fetus. But the work may one day raise profound questions about whether other animals, even humans, should or could be cultured outside a living womb.

In a study published in the journal Nature, Dr. Jacob Hanna described removing embryos from the uteruses of mice at five days of gestation and growing them for six more days in artificial wombs.

Two other papers published in Nature on Wednesday report on attempts that edge near creating early human embryos in this way. Of course, Dr. Meissner said, creation of human embryos is years away — if it is permitted at all. And for now, international regulations prohibit studying human embryos beyond 14 days of fertilization.

In the future, Dr. Tesar said, “it is not unreasonable that we might have the capacity to develop a human embryo from fertilization to birth entirely outside the uterus.”

Of course, even the suggestion of this science fiction scenario is bound to horrify many. But it is early days, with no assurance human fetuses could ever develop entirely outside the womb.

Even assuming they could, Dr. Tesar noted, “whether that is appropriate is a question for ethicists, regulators and society.”

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