COVID-19 affects pregnancy outcomes and why vaccination is important

The COVID-19 pandemic has posed unprecedented challenges for pregnant people and their babies. Several studies have shown that COVID-19 infection during pregnancy can increase the risk of adverse outcomes, such as preterm birth and stillbirth. However, vaccination against COVID-19 can reduce this risk and protect both the mother and the baby from the harmful effects of the virus.

What is preterm birth and stillbirth?

Preterm birth is defined as the delivery of a baby before 37 weeks of gestation. Preterm birth can have serious consequences for the baby’s health and development, such as breathing problems, bleeding in the brain, infections, and long-term disabilities. Preterm birth is also the leading cause of death among children under five years of age worldwide.

Stillbirth is defined as the death of a baby in the womb after 20 weeks of gestation. Stillbirth can have devastating emotional and psychological impacts on the parents and families, as well as physical complications for the mother, such as infection, bleeding, and increased risk of future pregnancy loss.

How does COVID-19 affect pregnancy outcomes?

Several studies have investigated the impact of COVID-19 infection during pregnancy on the risk of preterm birth and stillbirth. A large UK study, based on data from more than 340,000 pregnancies, found that COVID-19 infection around the time of birth was associated with a 60% increased risk of preterm birth and a 40% increased risk of stillbirth3. The study also found that the risk was higher for those who had severe COVID-19 symptoms or required hospitalization.

A similar study from California, US, based on data from more than 240,000 pregnancies, found that COVID-19 infection during pregnancy was associated with a 60% increased risk of very preterm birth (less than 32 weeks of gestation) and a 40% increased risk of any preterm birth4. The study also found that the risk was higher for those who had hypertension, diabetes, or obesity, as well as COVID-19.

The exact mechanisms by which COVID-19 infection during pregnancy increases the risk of preterm birth and stillbirth are not fully understood, but some possible explanations include immune dysregulation, inflammation, vascular damage, placental dysfunction, and fetal distress.

How does vaccination prevent COVID-19 and its complications during pregnancy?

Vaccination against COVID-19 is the most effective way to prevent COVID-19 infection and its complications during pregnancy. Several studies have shown that COVID-19 vaccines are safe and effective for pregnant people and their babies. A study from Israel, based on data from more than 7,000 pregnancies, found that COVID-19 vaccination during pregnancy did not increase the risk of adverse outcomes, such as preterm birth, low birth weight, congenital anomalies, or neonatal death6. The study also found that vaccinated mothers passed protective antibodies to their babies through the placenta and breast milk6.

Another study from California, US, based on data from more than 100,000 pregnancies, found that COVID-19 vaccination during pregnancy reduced the risk of preterm birth and stillbirth to pre-pandemic levels. The study estimated that vaccination prevented more than 8,000 preterm births and 200 stillbirths in California alone. The study also found that vaccination was beneficial for all racial and ethnic groups, as well as for those with underlying medical conditions.

What are the recommendations for pregnant people regarding COVID-19 vaccination?

The World Health Organization (WHO), the American College of Obstetricians and Gynecologists (ACOG), and the U.S. Centers for Disease Control and Prevention (CDC) all recommend that pregnant people should be offered COVID-19 vaccination, especially if they have risk factors for severe COVID-19, such as age, obesity, diabetes, or hypertension . They also recommend that pregnant people should be counseled about the benefits and risks of vaccination, and that their decision should be respected and supported .

The COVID-19 vaccines currently available are based on different technologies, such as mRNA, viral vector, or inactivated virus. There is no evidence that any of these vaccines pose a risk to pregnancy or fetal development, and they all induce a strong immune response against the virus . However, some vaccines may have different levels of efficacy and safety in different settings and populations, depending on the prevalence and variants of the virus, the availability and accessibility of the vaccines, and the individual characteristics and preferences of the recipients . Therefore, pregnant people should consult their health care providers and local health authorities to determine the best vaccine option for them.

COVID-19 infection during pregnancy can increase the risk of preterm birth and stillbirth, which can have serious and lasting consequences for the mother and the baby. However, vaccination against COVID-19 can reduce this risk and protect both the mother and the baby from the harmful effects of the virus. Pregnant people should be offered COVID-19 vaccination, especially if they have risk factors for severe COVID-19, and they should be counseled and supported in their decision. Vaccination is the best way to prevent COVID-19 and its complications during pregnancy.