The global emergence of COVID-19 introduced new considerations for public health, especially concerning vulnerable populations. Pregnant individuals, among these groups, face unique concerns about the virus’s potential effects on their health and their developing babies. Understanding current scientific evidence helps pregnant individuals and their families make informed decisions. This article provides clear, evidence-based information on how COVID-19 can affect pregnancy, exploring implications for maternal health, potential outcomes for the fetus and newborn, and the role of vaccination.
Maternal Health Implications
Pregnancy brings about physiological adjustments that alter a person’s response to infections, including COVID-19. The immune system undergoes modifications to prevent fetal rejection, sometimes diminishing the ability to fight pathogens. Respiratory changes, such as the diaphragm’s upward displacement, can reduce lung capacity, exacerbating respiratory symptoms. These adaptations, necessary for pregnancy, can increase susceptibility to severe illness from respiratory viruses.
Pregnant individuals contract the virus at a similar rate to non-pregnant adults. However, if infected, they face an elevated risk of severe outcomes, especially with pre-existing conditions like obesity, diabetes, or hypertension. This increased severity can manifest as a higher likelihood of hospital admission, intensive care unit (ICU) admission, and mechanical ventilation. Studies indicate a higher risk of complications and mortality for pregnant individuals with COVID-19.
Severe COVID-19 infection during pregnancy can lead to various maternal complications. These include heart damage, blood clots, and kidney damage. Moderate to severe forms of the illness have been associated with an increased incidence of preeclampsia, a condition involving high blood pressure. Severe maternal COVID-19 is also connected to a higher likelihood of preterm labor (birth before 37 weeks). These impacts highlight the importance of careful COVID-19 management in pregnant individuals.
Fetal and Neonatal Outcomes
Vertical transmission of SARS-CoV-2 from a pregnant individual to their baby is rare. While viral proteins can cross the placenta, direct active fetal infection before or during birth is uncommon. Newborns testing positive shortly after birth are often exposed during or immediately after delivery; most infants experience mild or no symptoms and fully recover.
Maternal COVID-19 infection can impact pregnancy outcomes even without direct fetal viral transmission. Studies link maternal infection to an increased risk of preterm birth (delivery before 37 weeks). Other associated adverse outcomes include low birth weight and, in some cases, stillbirth. These risks are pronounced with severe maternal COVID-19, and first or second-trimester infections may carry a higher risk for outcomes like preterm birth and stillbirth.
Newborns diagnosed with COVID-19 typically have mild or no symptoms. Symptoms can include fever, cough, nasal congestion, or feeding challenges. Rarely, more serious manifestations like breathing difficulties, lethargy, or persistent fever may require immediate medical evaluation. Ongoing research assesses potential long-term developmental effects for children exposed in utero or in early infancy, but current evidence suggests most recover without lasting health concerns.
Vaccination Considerations
Vaccination against COVID-19 is a primary protective measure for pregnant individuals and their babies. Leading health organizations, including the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the World Health Organization (WHO), recommend COVID-19 vaccination for pregnant individuals. Extensive data confirms the vaccines’ safety and effectiveness throughout pregnancy, supporting these recommendations.
Studies involving hundreds of thousands of pregnant individuals worldwide demonstrate that COVID-19 vaccines do not elevate the risk of adverse pregnancy outcomes like miscarriage, preterm birth, stillbirth, or birth defects. The vaccines do not contain live virus and cannot cause COVID-19 illness in the pregnant individual or developing baby. They also show no association with fertility challenges for those attempting to conceive. Evidence consistently suggests vaccination benefits during pregnancy outweigh theoretical risks.
Vaccination offers robust protection against severe COVID-19 illness for the pregnant individual, reducing hospitalization, ICU admission, and mechanical ventilation. This protection helps prevent severe maternal complications, including preeclampsia and preterm birth, which can result from severe infection. Beyond maternal protection, vaccination benefits the baby through passive immunity. Antibodies from the vaccinated pregnant individual transfer across the placenta, conferring protection to the newborn during their initial months, when they are too young for vaccination. Research indicates infants born to vaccinated mothers have a reduced risk of COVID-19 hospitalization.
Concerns about vaccine safety during pregnancy are common, but evidence-based information addresses them. Typical side effects, such as injection site soreness, low-grade fever, or fatigue, are generally mild and transient, mirroring experiences in non-pregnant populations. These reactions signify the immune system building protective antibodies. Healthcare providers discuss vaccination with pregnant individuals, offering clear, accurate information and addressing specific questions to facilitate informed decisions. Maintaining up-to-date vaccination status safeguards both the pregnant individual and the baby from COVID-19’s known impacts.