Covid raises risk of stillbirth, new research finds. What to know about vaccines during pregnancy

‘In September, the US Centers for Disease Control and Prevention recommended "urgent action" be taken to get pregnant people, and those who want to be pregnant in the future, vaccinated against COVID-19. The alert was issued after mounting evidence demonstrated how COVID-19 affected the outcomes of pregnancy and the overall health of the pregnant person. As of mid-September, only 31% of pregnant people were vaccinated against COVID-19 -- a much lower rate than the general US adult population -- but they had a 70% increased risk of dying from symptomatic COVID-19 compared to people who weren't pregnant. 

‘Now, research is showing that pregnant people with COVID-19 have a higher risk of their baby being stillborn, according to a November report by the CDC. While the overall rate of stillbirths was low from March 2020 to September 2021, people who had COVID-19 during their delivery had a 1.26% chance of stillbirth, compared to people without COVID-19 at .64% -- roughly double the risk. This risk was even higher, the CDC said, during the months the delta variant was circulating.’

Read here (CNET, Nov 23, 2021)

Risk of stillbirth has risen for women with Covid-19, CDC study shows

‘Pregnant women who tested positive for Covid-19 when admitted to a hospital to give birth were at a greater risk for stillbirth compared to those who did not, according to a study released by the U.S. Centers for Disease Control on Friday, with risks rising more since the delta variant has become the dominant strain.’

Read here (Forbes, Nov 19, 2021)

Read CDC report here.

Covid-19 vaccines don't raise miscarriage risk, three studies show

Pregnant women who received at least one dose of a COVID-19 vaccine were not at higher risk for miscarriage than their unvaccinated counterparts, according to a trio of new US studies:

Miscarriage no more likely in vaccinated: In the first study, published yesterday in JAMA, researchers from the Vaccine Safety Datalink (VSD) surveillance network used diagnostic and procedure codes and electronic health records to identify and assign gestational ages of miscarriages and ongoing pregnancies from Dec 15, 2020, to Jun 28, 2021... Read here.

More evidence of vaccine safety in pregnancy: Similarly, in a letter yesterday in the New England Journal of Medicine (NEJM), CDC scientists enrolled 2,456 women who were part of the agency's COVID-19 vaccine safety pregnancy registry... Read here.

A revised risk estimate: And in response to a letter yesterday in NEJM, a separate group of CDC researchers updated its analysis of 2,456 pregnant women who received one or two doses of an mRNA COVID-19 vaccine before conception or 20 weeks' gestation... Read here.

Read here (Center for Infectious Disease Research and Policy, Sept 9, 2021)

More risks to pregnant women, their newborns from COVID-19 than known before - Study

‘Pregnant women infected with COVID-19 and their newborn children face higher risks of complications than was previously known, a study by British scientists showed on Friday. An infection of the new coronavirus in such newborns is associated with a three-fold risk of severe medical complications, according to a study conducted by scientists at the University of Oxford. (https://bit.ly/3tNwkJ7)

‘Pregnant women are at higher risk of complications such as premature birth, high blood pressure with organ failure risk, need for intensive care and possible death. "Women with COVID-19 during pregnancy were over 50% more likely to experience pregnancy complications compared to pregnant women unaffected by COVID-19," said Aris Papageorghiou, co-lead of the trial and a professor of fetal medicine at Oxford University.’

Read here (Reuters, Apr 23, 2021)

Without official vaccine guidance, pregnant people are left to do their own research

‘The lack of clear guidance around pregnancy has ripple effects. Despite abundant evidence that the vaccines are safe for lactating parents and their babies, last month the Chicago Tribune reported that a new mom who was breastfeeding was denied the COVID-19 vaccine by her county’s health department. Officials said they decided not to allow pregnant or lactating women to receive the vaccine, citing a lack of data.

‘Dr. Peter Hotez, a vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine, told me he was appalled by the mixed messaging around vaccines in pregnancy, which he said leaves patients “reading the tea leaves.” The government “has not made a good faith effort to take down the anti-vaccine misinformation and disinformation,” he said. “So by telling a pregnant woman to do her own research online means you’re basically telling her not to get vaccinated.”

Read here (Mother Jones, Mar 4, 2021)

Pregnant during pandemic: The bump that no one saw

‘Sometimes I’m grateful for the isolation. I got to endure nausea in private, be exhausted in private and work from my couch on the days when it felt too hard to stand. Luckily for me, I had a job that allowed me to work from home. Luckily for me, I had a job at all. And as others also reported in a 2020 survey of 70 pregnant women in Ireland, taking a break from life’s fast pace while I grew another life did, at times, bring me peace.

‘My challenge instead has been letting go of the picture I had in my head of what pregnancy was “supposed” to look like. Gone is the fantasy of the Good Samaritan on the crowded bus giving up his seat for me or of colleagues in the hall asking how I’m doing. Also gone are the strangers trying to touch my belly or giving me unsolicited advice. Sometimes, without that constant feedback, I forget I’m pregnant. At other times, the aches and pains I feel in isolation seem stronger than they would be if someone was around to provide distraction.’

Read here (Scientific American, Feb 4, 2021)

Pregnant women get conflicting advice on Covid-19 vaccines

‘Pregnant women looking for guidance on Covid-19 vaccines are facing the kind of confusion that has dogged the pandemic from the start: The world’s leading public health organizations — the U.S. Centers for Disease Control and Prevention, and the World Health Organization — are offering contradictory advice. Neither organization explicitly forbids or encourages immunizing pregnant women. But weighing the same limited studies, they provide different recommendations.’

Read here (New York Times, Feb 2, 2021)

Pregnant women can pass antibodies to their foetus: Some implications for vaccinations

‘A study published in JAMA: Pediatrics provides evidence that pregnant women may be able to pass IgG antibodies against SARS-CoV-2 to their fetus. The study involved 1,417 women who recently gave birth. Among 83 mothers with detectable SARS-CoV-2 antibodies, 72 (86.7%) transferred IgG antibodies to their fetus—as detected in the newborns’ cord blood. IgM antibodies were not detected in any cord blood specimens, and antibodies were not detected in any infants born to mothers without detectable antibodies. The concentration of antibodies in the cord blood was significantly correlated with the concentration in the mother, but the antibodies were successfully transferred by mothers who exhibited symptomatic disease and asymptomatic infection. The study did not explicitly evaluate the ability to transfer antibodies developed as a result of vaccination; however, the researchers indicate that the results align with similar studies on transplacental transfer of vaccine-conferred antibodies for other diseases. Further research is necessary to determine the recommended timing for vaccination of pregnant women in order to achieve sufficient transplacental transfer of SARS-CoV-2 antibodies to the fetus.’ [John Hopkins Newsletter]

Assessment of maternal and neonatal cord blood SARS-CoV-2 antibodies and placental transfer ratios

‘Our findings demonstrate the potential for maternally derived antibodies to provide neonatal protection from SARS-CoV-2 infection and will help inform both neonatal management guidance and design of vaccine trials during pregnancy. Further studies are needed to determine if SARS-CoV-2 antibodies are protective against newborn infection; if so, at what concentration; and whether the transplacental kinetics of vaccine-elicited antibodies are similar to naturally acquired antibodies.’

Read here (Jama Pediatrics, Jan 29, 2021)