COVID-19 vaccination during pregnancy not associated with any observable birth defects on ultrasound – News-Medical.Net

In our latest interview, News Medical speaks to Dr. Rachel Ruderman, a fourth-year resident at Northwestern University Feinberg School of Medicine, about her current research, which reveals no detectable link on ultrasound scans between COVID-19 vaccination and birth defects.

My name is Rachel Ruderman. I am a 4thyear resident in obstetrics and gynecology at Northwestern University in Chicago. I love obstetrics -the changing physiology of pregnancy and how it impacts women and their children not only during pregnancy but after. Pregnancy can also expose significant future health risks and issues with social and economic support that really impact health.

Through the last two years of the pandemic, I have seen an amazing emergence of high-quality data and science on COVID in pregnancy and the development of lifesaving vaccines. Despite excellent evidence that COVID vaccines are safe and effective, many pregnant women have been hesitant to be vaccinated. Much of this stems back to pregnant people's initial exclusion from vaccine trials.

However, we now have a fund of research that supports the idea that the vaccine is safe and effective in pregnancy, while COVID during pregnancy can lead to worse maternal and fetal outcomes. Still - I noticed that a lot of my patients were hesitant to be vaccinated, and often cited their baby as the reason why. Thus, I wanted to look at whether getting the vaccine earlier in the pregnancy, during a key developmental time, as opposed to later in pregnancy or not at all, could be associated with an increased risk of birth defects.

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Birth defects are a large group of congenital abnormalities which include external structural defects (i.e. cleft lip) and internal structural defects(i.e. cardiac abnormalities). Major defects are extremely taxing to the neonate, the parents, and the healthcare system. For example, certain congenital cardiac anomalies require several surgeries, prolonged inpatient admissions, and high costs to the parents as well as the healthcare system.

Tons of research focuses on what we can tell our patients are safe and unsafe during pregnancy, especially during the critical period of organ development (the "Teratogenic Window") so we can prevent the physical, mental, social, and economic impacts of birth defects.

The study involved looking at patients who had a routine mid-pregnancy anatomy scan and documentation about vaccination status. If a vaccine was administered in pregnancy, we recorded at what point in pregnancy it was given. In Illinois, this is more easily done because of a state-wide database that records vaccinations and shares them with providers across different hospital systems (I-CARE [illinois.gov]). From there, we looked at the patient's demographics (age, number of pregnancies, self-reported race, and ethnicity), as well as other health issues like high blood pressure and diabetes.

With all this information, we were able to see if the timing of vaccination impacted anomalies discovered on these mid-trimester ultrasounds. We also looked at whether pre-existing conditions (like diabetes) or age impacted the presence of anomalies. We found no difference in the rate of anomalies between those vaccinated during the "Teratogenic Window" and those either vaccinated later in pregnancy or those not vaccinated at all. There was no increased risk after adjusting for those pre-existing conditions.

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TheCDC has a database called the V-safe registry, which looks at outcomes from pregnant women who have received the vaccines. They found no difference in outcomes in those who got the vaccine compared to controls. However, people that got the COVID vaccine early on are different from those who declined vaccination, and our study gives more information on these different patients. We looked at patients who not only declined vaccination but also got vaccinated later in pregnancy and discovered the same outcomes.

We know that pregnant patients with COVID have an increased risk forICU admission and intubation, as well as anincreased risk for high blood pressure disorders of pregnancy, preterm birth, and needing a c-section. What we know now in addition is that the vaccines developed for the general population are safe and effective for pregnant patients and help dramatically decrease these risks. We also know that antibodies from the vaccine werehigher than the antibodies people received from a COVID infection.

I have seen firsthand the misinformation online and how it has made my patients skeptical of getting the vaccine during pregnancy. The more we can counter this dangerous messaging with real, high-quality data, the better and safer our patients and their babies will be. It's so important to break down this information so the general public can really understand for themselves what the evidence is and make decisions that can benefit them in the long run.

I have noticed that having conversations with my patients that are honest and open is the most helpful. I always ask people why they are hesitant or concerned, and then try to explain my recommendations using the significant amount of evidence we have on the Covid vaccine during pregnancy.I always check if my pregnant and postpartum patients are vaccinated and boosted. Talking with patients one on one and validating their concerns can go a long way.

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Next year I will be a Maternal Fetal Medicine fellow at the University of Chicago taking care of high-risk pregnancies (sick moms and babies). I plan to do research on the postpartum period and would love to look at the postpartum experiences of women who were vaccinated against COVID or infected with COVID during pregnancy.

I would always recommend checking out reputable sites like the CDC and WHO. There's a lot of great COVID information for patients on ACOG's website (the American College of Obstetricians and Gynecologists). There's a lot of misinformation online so it's important to make sure the sources you're accessing are legitimate!

Readers can find the full study at: https://news.northwestern.edu/stories/2022/03/covid-19-vaccine-not-associated-with-birth-defects/?fj=1

Rachel Ruderman is a native of Chicago. She attended the University of Michigan where she studied Global Health and received a Master of Public Health. She returned to Chicago for medical school and stayed for residency at Northwestern. During her tenure at Northwestern, she has published on issues of accessing quality postpartum care.

Rachel also developed awomen's health advocacy curriculum and established an infertility education program at Chicago's John H. Stroger Jr Hospital, a safety net hospital in the city. Next year she will be a Maternal Fetal Medicine fellow at the University of Chicago where she plans to do research on the postpartum period.

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COVID-19 vaccination during pregnancy not associated with any observable birth defects on ultrasound - News-Medical.Net