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COVID-19 & Pregnancy – One year later

It’s been over a year since the COVID-19 pandemic was declared. During this time, we have gathered a lot of information and continue to learn and adjust our lifestyles. More and more people are joining the pandemic pregnancy club – an experience like no other. Here’s what we know right now about COVID-19 and pregnancy:

 

Pregnancy

The limited research available suggests pregnant people are more severely affected by COVID-19 infections. During pregnancy COVID-19 may be associated with a higher likelihood of severe illness and adverse effects such as higher chance of hospitalization and ICU admission due to respiratory complications. Some research suggests pregnant people with COVID-19 have higher rates of preterm delivery, preeclampsia, cesarean section and their babies are more likely to be admitted to the NICU. 

 

Bottom line: COVID-19 can cause severe illness (whether you’re pregnant or not) so you want to minimize your risk of catching the virus. Pregnant people should be aware of the increased chance of severe illness and pregnancy complications that COVID-19 can cause.

 

Newborns

The risk of vertical COVID-19 transmission (an infected person passing the virus to the baby in utero) is low. Studies have shown that infants born to COVID-19 positive birthing people are rarely born with the virus.

 

Vaccine

There are a number of COVID-19 vaccines that are considered safe and effective. There are currently four approved vaccines in Canada: Moderna, Pfizer-BioNTech, AstraZeneca and Janseen. Moderna and Pfizer are mRNA vaccines and AstraZeneca and Janseen are viral vector-based vaccines. It typically takes two weeks after being fully vaccinated to build immunity. The efficacy of the various vaccines ranges from greater than 60% to greater than 90%. Most importantly, almost all vaccines are close to 100% effective against severe COVID-19 illness.

 

Vaccine & pregnancy

For a number of reasons, initial COVID-19 vaccine clinical trials did not include pregnant people. However, based on what is known about vaccines and recent studies, it is believed it is safe to take the COVID-19 vaccine during pregnancy. The Society of Obstetricians and Gynaecologists of Canada (SOGC) says people who are pregnant or breastfeeding should be offered COVID-19 vaccination at any time during pregnancy if they are eligible and there are no known reasons not to take the vaccine (such as allergies etc). On April 15, 2021 the SOGC released a statement saying that the Ontario government should immediately prioritize people who are over 20 weeks pregnant for the COVID-19 vaccine. 

 

Recent studies have found COVID-19 mRNA vaccines to be effective during pregnancy and lactation and that antibodies transfer to the infant. This means pregnant or lactating people can pass on antibodies through the placenta while pregnant or through breastmilk if breastfeeding/chestfeeding. 

 

Vaccine & fertility

Currently there is no evidence to suggest a link between COVID-19 vaccination and infertility. Those that are trying to get pregnant do not need to postpone getting the vaccine.

 

Prevention

Prevention remains important during this pandemic. Reduce your risk of infection by limiting your contact with others as much as possible and avoid contact with symptomatic people. Wear a mask in public and wash your hands frequently. The SOGC recommends that pregnant people who are frontline workers should discuss moving to lower exposure type work if possible. 

 

In closing

We are continuing to learn about COVID-19 and pregnancy. With increasing numbers of pregnant COVID-19 patients in ICUs, doctors believe that pregnant people may be particularly vulnerable to COVID-19 variants. Pregnant people should continue to be mindful and take precautions whenever possible to reduce their chance of contracting the virus. Our knowledge of this virus continues to evolve, so stay up to date with recommendations and protocols. Speak to your primary care provider and use trusted resources for information.

References

 

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773105?resultClick=1https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e2.htm

https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e2.htm

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-and-covid-19-what-pregnant-women-need-to-know

https://drive.google.com/file/d/1olxna_tRUgtw8xqZpltydEokpD7M9CR1/view

https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines.html

https://www.sogc.org/common/Uploaded%20files/Latest%20News/SOGC_Statement_COVID-19_Vaccination_in_Pregnancy.pdf

https://www.ajog.org/article/S0002-9378(21)00187-3/fulltext

https://www.bmj.com/content/372/bmj.n509

https://www.pregnancyinfo.ca/covid/#prevention

https://instagram.com/pandemicpregnancyguide?igshid=y5b0izmxlix0

https://www.sogc.org/common/Uploaded%20files/Latest%20News/EN_Statement-COVID-19_PregnantWomen.pdf

https://toronto.ctvnews.ca/toronto-hospital-reports-alarming-number-of-pregnant-patients-in-covid-19-icu-1.5393855

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