Are Pregnant Women at Higher Risk with COVID-19?

Reviewed on 4/8/2022
Are Pregnant Women at Higher Risk with COVID-19?
Pregnant women are more likely to become severely ill from COVID-19 compared to other people.

COVID-19 is a novel (new) coronavirus, not previously identified in humans, and responsible for an outbreak of respiratory illness that became a global pandemic in 2020. COVID-19 is different from other coronaviruses that cause mild illness, such as the common cold.

Both pregnancy and COVID-19 increase the risk of developing blood clotting problems. Pregnant or recently pregnant people are more likely to become severely ill from COVID-19 compared to people who are not pregnant. Severe illness from COVID-19 can be fatal. 

Severe illness with COVID-19 may necessitate:

  • Hospitalization
  • Admission into an intensive care unit (ICU)
  • A ventilator or special equipment to help them breathe

COVID-19 is also associated with an increased risk for pregnancy complications, and an increased risk of: 

  • Delivering a preterm (earlier than 37 weeks) baby
  • Stillbirth
  • Needing a cesarean delivery
  • Serious illness from hypertensive disorders of pregnancy
  • Postpartum hemorrhage
  • Infections other than SARS-COV-2
  • Loss of pregnancy 
  • Maternal death around the time of birth
  • The infant dying during the newborn period

Mild or asymptomatic infection was not associated with increased pregnancy risks.

Can You Get the COVID-19 Vaccine if You Are Pregnant?

The Centers for Disease Control (CDC) recommends all eligible individuals be vaccinated against the virus that causes COVID-19. The U.S. Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for COVID-19 vaccines to allow for the use of a booster dose as well. This includes people who are pregnant. 

The American College of Obstetricians and Gynecologists (ACOG) recommends all eligible persons aged 12 years and older, including those who are pregnant and lactating, receive a COVID-19 vaccine or vaccine series. 

The mRNA COVID-19 vaccines such as the Pfizer-BioNTech COVID-19 vaccine (Comirnaty) and Moderna COVID-19 vaccine (Spikevax) are preferred over the Janssen (Johnson & Johnson) COVID-19 vaccine for all vaccine-eligible individuals, including those who are pregnant and lactating, for primary series, primary additional doses (for immunocompromised persons), and booster vaccination.

All three of the COVID-19 vaccines authorized for use in the U.S. have been shown to be highly effective in reducing the risk of severe disease, hospitalization, and death.

Can You Get the COVID-19 Vaccine Booster if You Are Pregnant?

Antibodies produced from the vaccines that help protect against COVID-19 wear off over time. A COVID-19 vaccine booster helps extend the protection for a longer period. Emergency use authorizations (EUAs) for COVID-19 vaccines allow for the use of a single booster dose. 

The ACOG recommends pregnant and recently pregnant people up to six weeks postpartum receive a booster dose of the COVID-19 vaccine following the completion of their initial COVID-19 vaccine or vaccine series.

Each of the available COVID-19 vaccines may be used as a “mix and match” booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine.

Can the COVID-19 Vaccine Affect Fertility?

The Centers for Disease Control (CDC) recommends all eligible individuals be vaccinated against the virus that causes COVID-19. The U.S. Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for COVID-19 vaccines to allow for the use of a booster dose as well. 

There is currently no evidence that any of the COVID-19 vaccines cause fertility problems in women or men. Studies have found no differences in pregnancy success rates among women who had antibodies from COVID-19 vaccines or from a recent COVID-19 infection and women who had no antibodies, including for patients who used assisted reproductive technology procedures (e.g., in vitro fertilization). One study of more than 2,000 females aged 21-45 years and their partners found COVID-19 vaccination of either partner did not affect the likelihood of becoming pregnant.

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Reviewed on 4/8/2022
References
Image Source: iStock Images

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.covid19treatmentguidelines.nih.gov/

https://www.nih.gov/news-events/news-releases/nih-funded-study-suggests-covid-19-increases-risk-pregnancy-complications

https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care?utm_source=redirect&utm_medium=web&utm_campaign=int

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/planning-for-pregnancy.html