Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.
Making safety judgments for two is a daunting responsibility during pregnancy. Mothers-to-be are cautious about medications, food, alcohol and cigarettes and anything else that could harm fetal development during this crucial window of time. During the COVID pandemic, that concern has understandably included questions about vaccination against this new viral threat.
Parental due diligence ought now include a critical new review of medical studies involving COVID vaccination during pregnancy. Last week, Nature, a highly respected journal, published a systematic analysis of multiple medical studies.
The resulting article is a powerful yet accessible summation of the accumulated science, with data overwhelmingly supporting vaccination. The evidence evaluated 23 studies that included 117,552 vaccinated pregnant women, who "almost exclusively" received mRNA vaccines, meaning either Moderna or Pfizer.
The two-shot series offered impressive protection against infection — close to 90% in the time window studied. In addition, the review found "no evidence of a higher risk" of adverse outcomes such as:
- Premature birth.
- A lower birthweight score.
- Pulmonary embolism.
- Placental abruption, a severe condition that can reduce fetal oxygen and nutrients.
A special note about the last tragic condition listed — stillbirth: Getting vaccinated against COVID may reduce the risk. The Nature analysis reported a "15% decrease in the odds of stillbirth" in those vaccinated, though it also cautioned against interpreting the results as causal.
The authors, however, do not hesitate to draw broader conclusions to guide doctors and pregnant women. "This provides further evidence that the risks of COVID-19 outweigh the rare risks of vaccination in pregnancy, and pregnant people should be encouraged to pursue vaccination, even in the first trimester,'' they write.
The authors are qualified experts — generally British medical specialists. The publication also took a welcome extra step. The data analyzed is available in a shareable database for anyone wanting a closer look. This transparency, as well as the researchers' careful interpretation of their findings, inspires confidence.
In an age when so many people personally research medical decisions, the new Nature analysis is a must-read for those expecting or planning to add to their families.
More than two years into the pandemic, it's clear that COVID will not be eradicated. Sadly, the virus is a particular health threat during pregnancy. "Among women of reproductive age with COVID-19, pregnant women are more likely to be hospitalized and at increased risk for ICU admission and receipt of mechanical ventilation compared with nonpregnant women," according to a report from the U.S. Centers for Disease Control and Prevention.
Among the reasons that pregnancy may increase COVID complications risks: immune system changes and stress on both the heart and lungs. "It's well known that pregnancy boosts the risk of serious disease from respiratory viral infections. During the H1N1 flu epidemic of 2009, pregnant women accounted for 5% of U.S. deaths, although they constituted about 1% of the population,'' reported an article published in Science.
Dr. Sarah Cross, an assistant professor of obstetrics, gynecology and women's health at the University of Minnesota Medical School, reviewed the Nature analysis and pointed out the data's striking consistency — "across the board" favorability — when it comes the COVID vaccination's safety and effectiveness during pregnancy.
Cross, medical director of The Birthplace at M Health Fairview and a mother of three young children, empathizes with patients navigating the careful choices pregnancy requires. She tells expecting patients that the "most important thing for the baby is for you to be healthy." The COVID vaccination, Cross said, is "how you keep yourself healthy."
For those who still have questions, seek out a medical provider. Said Cross: "We want to talk to you. We want to help you be safe. Just ask us."