March 14, 2022
3 min read
Source / Information
Information: Minkin does not report any relevant financial information. Stock reports receiving support for research into COVID-19 during pregnancy, paid to her institution.
Results have shown that COVID-19 mRNA vaccines are safe and effective during pregnancy, and evidence also suggests that the benefits of maternal vaccination include newborns.
But despite the results of the vaccines and those adverse health outcomes associated with COVID-19 during pregnancyvaccine intake among pregnant women has remained lower compared to the general population.
A recent analysis showed that pregnant women are motivated to be vaccinated if health professionals explain how immunization benefits their baby. We spoke with experts about the safety of COVID-19 vaccines during pregnancy and studies showing how maternal vaccination can protect infants.
‘Primum non nocere’
In a study published this year, Goldshtein and colleagues found that the number of preterm births, neonatal hospitalizations for all causes, post-neonatal hospitalization, congenital anomalies, and infant mortality were similar for newborns who were and were not exposed to the Pfizer-BioNTech vaccine in utero.
Mary Jane Minkin
“The two important principles of medicine are ‘primum non nocere’ and ‘secundum bene facere’ – first, do no harm; second, do it well,” Mary Jane Minkin, MD, clinical professor in the department of obstetrics, gynecology and reproductive science at the Yale School of Medicine, Healio said. “[This study] clearly outlines no harm … and there are other studies out there that confirm this. “
Such a study showed that babies who were exposed to the vaccine during their mothers pregnancy did not interfere fetal brain development.
‘Secundum bene facere’
Several studies have shown that newborns can benefit from maternal vaccination that meets the “do good” principle that Minkin alluded to.
In one study, Yang and colleagues evaluated levels of anti-spike immunoglobin G (IgG) antibodies in pregnant women who had received at least one dose of either the Moderna, Pfizer-BioNTech or Johnson & Johnson vaccines. Their data showed that being fully vaccinated at any time during pregnancy was associated with the presence of maternal antibodies.
Conti and colleagues examined a contrasting cohort – mothers with COVID-19 – and found that infants had antibodies in their saliva, “which may partly explain why newborns are resistant to SARS-CoV-2 infection,” he said. the. They also found that antibodies can be transmitted through breast milk to newborns.
Despite this apparent benefit of infection, Yang and colleagues discovered that vaccination in the third trimester yielded maternal and umbilical cord antibody titers comparable to those observed in women with previous SARS-CoV-2 infection. In addition, they found that receiving a booster shot in the third trimester was associated with an even greater concentration of antibodies than natural infection.
Another study conducted by Kugelman and colleagues supported these findings, specifically regarding the Pfizer-BioNTech vaccine administered in the second trimester. Although both mothers and their babies in this study had humoral reactions, newborns had a 2.6 times higher level of antibodies compared to their mothers.
This transfer of antibodies is essential to protect the youngest children, Minkin stressed.
“Newborns are basically immunocompromised; they can not make antibodies when they are born, ”said Minkin, who is also a board member of Healio Women’s Health & OB / GYN Peer Perspective. “No trial of immunizing children will look at newborns under 6 months old, so it is important to get this vulnerable group of antibodies.”
Looking past the neonatal stage, Shook and colleagues found that 57% of infants aged 6 months whose mothers had been vaccinated during pregnancy had retained antibodies, compared with 8% of those whose mothers were infected with SARS-CoV-2 during the pregnancy. Although this study was small, “these results provide additional incentive for pregnant women to pursue COVID-19 vaccination,” the researchers wrote.
The importance of vaccination
As data continue to support the benefits of maternal COVID-19 vaccination for newborns, doctors must continue to advocate for vaccination of pregnant women, according to experts.
“There is now good evidence that vaccination is the safest and most effective way for pregnant women to protect themselves and their babies from COVID-19 infection,” Sarah Stock, MD, PhD, a reader in maternal and fetal health and an honorary consultant and subspecialty in maternal and fetal medicine at the University of Edinburgh Usher Institute, Healio said. “If you are at any point in your pregnancy or hoping to become pregnant, I would strongly encourage you to get vaccinated.”
In view of this data and increased risk of pregnancy complications associated with COVID-19Minkin said it is better for pregnant women to be vaccinated than to risk infection.
“All these [studies] demonstrate that maternal vaccination is safer for the mother but also safer for her newborn, so why not get the vaccination? “she said.” We often do not get the opportunity to take a win-win situation. “