Is the PRESTO team studying COVID-19 and Reproductive Health?
The PRESTO team is currently analyzing all aspects of the COVID-19 pandemic including infection, vaccination and associated stress with reproductive outcomes and will update our participants on published literature when it becomes available.
What data is there about COVID-19 vaccination on fertility and pregnancy?
Pregnant people and those trying to conceive were excluded from the original COVID-19 vaccine trials. Some people participating in the trial were pregnant, but not did know it yet and among these individuals, no significant adverse events were observed. The American College of Obstetricians and Gynecologists recommends that “Pregnant people have access to the COVID-19 vaccine.” See more here: https://www.nature.com/articles/s41577-021-00525-y.pdf
To date (May 20th 2021), over 114,000 pregnant people in the U.S. have received a COVID-19 vaccination. Side effects (such as pain, swelling, fatigue, and fever) appear similar in pregnant and non-pregnant people. See more here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
Close to 5,000 pregnant people have enrolled in the V-safe pregnancy registry, which is actively following up pregnancies to examine risk of adverse outcomes including miscarriage, stillbirth, pregnancy complications, maternal ICU admission, adverse birth outcomes, neonatal death, infant hospitalizations, and birth defects. See more here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafepregnancyregistry.html
Vaccine trials in pregnant people began in February. We expect some preliminary data from these trials will be coming out within the next few months.
What is the risk of COVID-19 for pregnant people?
There is good scientific evidence that pregnant people infected with COVID-19 are at increased risk of severe illness compared with non-pregnant people. For this reason, in many states, pregnant people were prioritized for vaccination. See the whole study here: https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e3.htm
How has prenatal care been affected by the COVID-19 pandemic?
The American College of Obstetricians and Gynecologists updated their guidance in December 2020. In that statement, they acknowledge that public health efforts such as social distancing may have unintended consequences on the accessibility of prenatal care. Ensuring that everyone is given the necessary amount of prenatal care remains a priority for OB/GYNs; however, telehealth may be used more frequently instead of in-office visits. See more here: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019
How has hospital care and labor and delivery been affected by the COVID-19 pandemic?
Couples should check with their providers about the specifics of hospital care. There are likely COVID-19 policy changes regarding Labor and Delivery Units. Visitation may be limited to 1-2 people, in-person tours of the birthing suites may be unavailable. For more about clinical care during pregnancy and birth you can visit: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019 and contact your preferred provider for more specific information
Can infants contract the virus causing COVID-19? How dangerous is it?
Transmission of the COVID-19 virus to newborn infants is thought to occur primarily through respiratory droplets after birth when newborns are exposed to parents and caregivers with the virus. There are limited reports that have raised concern over transmission in utero, during birth or shortly after birth. These rare infections are often asymptomatic or mild cases not requiring respiratory support. Preterm infants may be at higher risk of severe COVID-19 complications. See more here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-newborns.html
Can infants acquire COVID-19 antibodies through vaccination during pregnancy?
In a recent study, the new mRNA COVID-19 vaccines were highly effective in transmitting antibodies to fetuses and newborns in pregnant and lactating people. The antibodies generated by the vaccine were present in umbilical cord blood as well as breast milk samples of all people studied. See the whole study here: https://www.ajog.org/article/S0002-9378(21)00187-3/fulltext
Can infants acquire COVID-19 antibodies through infection during pregnancy?
Another study detected no COVID-19 virus in the placentas of people who were infected during pregnancy, and little evidence of transmission of the virus or antibodies in utero. Researchers suspect that transmission to the fetus may be blocked due barriers in the placenta. See the whole study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774428
We hope you find this information reassuring that a safe and healthy pregnancy is possible during the COVID-19 pandemic. Additionally, we believe that the data so far is reassuring that COVID-19 vaccination is safe in pregnancy. We recommend consulting with your obstetrician before making any choices about your healthcare during pregnancy.
We are happy to address any additional questions. You can contact us at firstname.lastname@example.org. Thank you for your interest and participation in PRESTO.