With all of the new information out there about pregnancy, COVID-19 infection, and vaccination, it’s difficult to know what’s best for you and your growing baby.

What are the risks of COVID-19 infection during pregnancy vs. receiving the COVID-19 vaccine when pregnant? 

To vaccinate or not to vaccinate? 

If you’ve felt overwhelmed trying to navigate all of this new information, you are not alone. But look no further: the purpose of this article is to clear up any misconceptions surrounding COVID-19 and pregnancy for expecting, or planning, mothers-to-be.

If I become infected with COVID-19, can it spread to my baby? 

The short answer is: it’s possible, but very unlikely. The latest studies show us that anywhere between 1% and 7% (depending on the study) of infected, pregnant women pass on COVID-19 infection to their unborn baby [1] [3]. With respect to spreading infection to your baby through breastfeeding, this has been found to be even more unlikely. This is great news for all nursing mothers out there [1].

Are pregnant women at a higher risk of getting COVID-19? 

At this time, the science shows that pregnant mothers are not at a higher risk of becoming infected with COVID-19 compared to the general population [1] [3]. We’ve also seen that when most pregnant women become sick with COVID-19, they tend to show either no symptoms, or have mild symptoms including fever, cough, and shortness of breath [1] [3].

Do pregnant women develop more serious infections due to COVID-19 than women who are not pregnant?

This is where the evidence becomes more concerning for pregnant women. While many pregnant women will have no symptoms or mild symptoms due to COVID-19 infection, pregnant women ARE more likely to develop more serious symptoms and have worse outcomes when they become infected with COVID-19, in comparison to non-pregnant women of the same age [1] [2].

What exactly does this mean? Large studies have found that between 7-11% of pregnant women will require hospitalization for COVID-19 infection, and 1-4% of pregnant women will require admission to the intensive care unit [1] [2]. These numbers are concerning for pregnant women. This tells us that pregnant women are at a higher risk of requiring admission to the hospital, and needing life-saving interventions such as a breathing tube, when compared to non-pregnant women of the same age, if they become sick with COVID-19 [1]. The news is even more concerning for pregnant women with other risk factors. Pregnant women who are 35 years of age or older, have other health conditions like asthma, diabetes, high blood pressure, or heart disease, or who are obese, are more likely to get more sick if they become infected with COVID-19 [1] [2].

If I get COVID-19, what does this mean for my baby? 

The most common complications of COVID-19 infection during pregnancy are pre-term delivery, increased risk of low birth weight in your baby, and need for C-section delivery [1] [4]. Pre-term delivery itself can be dangerous for your baby as it is known to cause heart problems, lung problems, poor growth, high blood pressure, and many other health conditions, depending on exactly how early your baby is born [4].

Should I get the vaccine? 

This is the difficult one, particularly because the purpose of this article is not to offer medical advice, but to discuss available scientific information. It is also difficult because pregnant women were excluded from initial clinical trials of the COVID-19 vaccine, limiting the data that is available to us.

But the good news is that more information has become available about the COVID-19 vaccines in pregnant women in recent months. In the US, almost 4000 pregnant women have received either their Pfizer-BioNTech or Moderna vaccine. Of these 4000 women, there have been no documented health issues with the pregnancy or the baby when they are born [2] [3]. These COVID-19 vaccines are also expected to have very little risk for breastfeeding women, just like many other vaccines we use today [2] [3].

What we do know is that when pregnant women become infected with COVID-19, they are more likely to require admission in the hospital and require life-saving interventions than non-pregnant women of the same age [1] [2]. It is for this reason that the Society of Obstetricians and Gynecologists of Canada (SOGC) recommends all pregnant and breastfeeding women be offered the COVID-19 vaccine, Pfizer-BioNtech or Moderna, at any time during pregnancy if these women do not have any other health concern that prevents them from getting the vaccine [2].

This is a difficult decision to make as pregnant and breastfeeding women want to do what is best for their child. The decision to receive the COVID-19 vaccine is a very personal one, that should be carefully considered with your Obstetrician, who can help you weigh the risks and benefits of receiving the COVID-19 vaccine while pregnant.

Stay safe during these uncertain times, and we wish you all the best moving forward with your pregnancy, and as we prepare to hopefully leave these uncertain times behind us.

Important Points

1. 1. Pregnant women are not at higher risk of getting COVID-19 than non-pregnant women. 
2. 2. If you get COVID-19, there is a low risk of spreading the infection to your baby while pregnant or breastfeeding.
3. 3. Pregnant women are more likely to have life-threatening illness from COVID-19 than non-pregnant women of the same age. 
4. 4. COVID-19 infection while pregnant increases the risk of delivering a premature baby, which can cause many health problems for your baby.
5. 5. Vaccinate! Either Pfizer or Moderna are currently recommended for pregnant women in Canada at any time during pregnancy. 

References

1.Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of COVID-19 pandemic on maternal and perinatal health: a scoping review. Reprod Health. 2021; 18(10):1-39.

2.Poliquin V, Castillo E, Boucoiran I, Wong J, Watson H, Yudin M, Money D, Van Schalkwyk J, Elwood C on behalf of The Society of Obstetricians and Gynecologists of Canada. May 25, 2021. Available at https://www.sogc.org/common/Uploaded%20files/Latest%20News/SOGC_Statement_COVID-19_Vaccination_in_Pregnancy.pdf

3.Rasmussen S, Kelley C, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID-19) vaccines and pregnancy: What obstetricians need to know. Obstet Gynecol. 2021; 137(3): 408-14.

4.Thuy Mai L, Mian M, Nuyt AM. Long-term impact of preterm birth neurodevelopmental and physical health outcomes. Clinics in Perinatology. 2017; 44(2): 305-14