As I was compiling this information for our Mama’s here in GTA. I just thought I will share this with other Mamas across the globe.

This might not be of use to all the people here, but knowledge never goes a waste, you may use it to help someone else with it.

Last year and this year has been a difficult experience for all of us, as the world reels under the effects of a global pandemic.

WHO declared a Global pandemic of Covid-19 virus.

Covid-19 virus has the potential to cause illness with some very severe symptoms in some people requiring admission to ICU and ventilator support and is even fatal to some people.

In most people it causes is a mild to moderate illness or no illness.

It is difficult to find out accurately, which people will get very sick with covid-19.

Therefore everyone has been following Public health guidance to stay safe.

The pandemic, has impacted almost every sphere of our life, physical health, mental health, relationship health, social health, financial health.  

The good news is that, we are finally seeing light at the end of the tunnel with the mass vaccinations. Hang in there a tad bit longer folks! We are getting there. While the challenges have increased for all of us, pregnant women are one of the groups that is disproportionately affected by the severity of Covid-19 infection.

Here is some information compiled from reliable sources of information. This information is general in nature to support informed decision making. It does not replace or substitute advice of your primary care provider.

Lot of this information is fast evolving and this is current at the time of the post.

Should I take the Covid-19 Vaccine if I am Pregnant?

Some of the relevant issues that need consideration to arrive at an informed decision are:

´  What are my chances of getting infected with Covid-19?

´  What are the Consequences of Covid-19 infection on pregnant individuals and their babies?

´  Risks vs Benefits of taking the Covid-19 Vaccine?

´  Validity of Data

 

What are my chances of getting infected with Covid-19?

´  Am I living in a community where there is a high risk of getting infected with Covid-19?

´  Does my work bring me in close contact with other people possibly infected with Covid-19?

´  Is someone in my household working in an environment where they can get infected with Covid-19?

 

 

Consequences of Covid-19 infection for pregnant women

´  Pregnant individuals infected with Covid-19 have a higher chance of requiring hospitalization, ICU admissions and ventilator support compared to non-pregnant individuals.

´  Pregnancy does not increase the chance of getting infected with Covid-19

´  Society of Obstetricians and Gynecologists of Canada estimated that approximately 1 in 10 pregnant women would need hospitalization and 1 in 100 will require intensive care. These numbers likely will be higher in those with Comorbidities.

´  Providing ventilator support in pregnancy is more challenging.

´  Pregnant women with Covid-19 are more likely to have premature birth and Caesarean delivery.

 

How have the Variants of Concern impacted hospital admissions and ICU admissions for pregnant women?

Variants of concern means, newer versions of virus which are either more transmissible or cause greater severity of disease as compared to the original one.

´  First and the second waves of Covid-19 pandemic showed higher rates of hospitalization, ICU admission and ventilation in pregnant individuals relative to non-pregnant individuals.

´  In this third wave of the pandemic as infection rates in younger people are higher and variants of Concern are predominant in some areas. Providers and media are reporting worsening consequences for pregnant individuals infected with Covid-19.

´  According to SOGC members “Pregnancy is a known factor for Covid-19 associated morbidity with data clearly and consistently illustrating that pregnant individuals are at increased risk of hospitalization, ICU admission, mechanical ventilation and death compared to Non pregnant individuals.”

 

How does Covid-19 Infection affect my baby?

´  There is currently no evidence to suggest that Covid-19 causes fetal malformations or other developmental problems. However, more data needs to be collected on this.

´  Preterm birth rate is twice the rate of general population.

´  Incidence of still births was 15.9% and general incidence of stillbirth is 13.2%, but because absolute number of still births was very low so it should be interpreted cautiously. More data is awaited on this issue.

´  Data shows that transmission of infection from mother to baby is low, most newborns test negative.

´  Most newborns developing Covid-19 soon after birth, will do well.

´  The number of NICU admissions for babies of mothers infected with Covid-19 was higher than normal.

 

 

Based on the risks identified for pregnant women and their babies, some recommendations have been made.

 

Society of Obstetricians and Gynecologists of Canada – Consensus Statement

 

´  Women who are pregnant or breastfeeding should be offered vaccination at any time during pregnancy if they are eligible and no contraindications exist.

 

´  SOGC supports use of all vaccines approved for use in Canada, in any trimester of pregnancy.

 

´  Given that pregnant individuals are at increased risk of morbidity from Covid-19 Infection, all pregnant individual should be eligible to receive Covid-19 vaccine.

 

´  The decision to vaccinate is based on women’s personal values and an understanding that the risk of infection and/or morbidity from Covid-19 outweighs the theorized and undescribed risk of being vaccinated during pregnancy and breastfeeding. Women should not be precluded from vaccination based on pregnancy status or breast feeding

 

Vaccines currently approved are Moderna and Pfizer, Covishield (Astra-zeneca is now on hold because of the blood clot problems)

 

Vaccine preferable for pregnant population are Pfizer and Moderna.

Astra-zeneca can be taken but is not the preferred one due to its blood clots issues as pregnancy itself is a state that promotes blood clots. The observed condition is being called by some hematologists “vaccine-induced prothrombotic immune thrombocytopenia” (VIPIT). This syndrome has not yet been proven to be vaccine induced but has been observed in persons receiving the vaccine within 4-20 days. The actual rate of occurrence is unclear as all data from global observations are not yet available. It appears to be extremely rare, occurring in anywhere from 1 in every 125,000 to 1 in 1 million people following AstraZeneca/COVISHIELD COVID-19 vaccines. You can follow this with the link below.

https://sogc.org/en/content/featured-news/SOGC_statement_on_the_COVID-19_AstraZeneca_vaccine.aspx

What are the potential Risk vs Benefits of Covid-19 vaccine?

´  Limited data on effects of Covid-19 Vaccine on pregnancy and the baby as it is fairly recent, trials are underway.

´  There is data from about a 100,000 women vaccinated in the US

´  Data also comes from the women who were in the vaccine trials and became pregnant.

´  Currently, there is no evidence of any major problems in these women or their babies.

´  Currently there is no data on long term effects of vaccine on baby, this is theoretical and undefined consideration at this time.

´  Benefit of taking the vaccine is preventing severe Covid-19 infection in both mother and baby.

´  Hence the recommendation is to take the vaccine in any trimester, if not otherwise contraindicated.

 

Reliability of Data on Covid-19 vaccination in pregnancy.

 

´  We do have data on about 100,000 pregnant women who have received Covid-19 vaccine in the US and there have been no reported ill effects of the vaccine noted.

´  We also have data from women volunteers, who did become pregnant during the vaccine trials.

´  Although we would like to have more data on Covid-19 vaccines and pregnancy,

´  We do have a lots of research data spanning decades in general on other vaccines and their efficacy and safety in pregnancy.

´  We also have reliable data from animal studies and opinions from the experts in the field, reporting that Covid-19 vaccination can be safely used in pregnant women.

 

References

´  Cancovid-Preg report released in Feb 2021: Canadian Surveillance of COVID-19 in Pregnancy: Epidemiology, Maternal and Infant Outcomes – Reproductive Infectious Diseases Program (ubc.ca)

´  Data Compiled by Born Ontario: COVID-19 and Pregnancy: Information at your Fingertips – Prenatal Screening Ontario (bornontario.ca)

´  Society of Obstetrician and Gynecologists of Canada: SOGC_Statement_COVID-19_Vaccination_in_Pregnancy.pdf

´  Society of Obstetrician and Gynecologists of Canada: SOGC statement regarding pregnant women and individuals with COVID-19 in ICUs in Ontario

´  Centres for disease control and prevention: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

´  Provincial council for maternal and child health: https://www.pcmch.on.ca/covid-19vaccine

 

Caring for a newborn when the mother has Covid-19

´  Most babies born to women with Covid infection will test negative, some will be positive and most of these babies will have a mild to moderate disease. Although few babies have developed severe illness with Covid.

´  Woman can choose to room in with the baby as the risk of transmission in babies is low, especially if mother takes adequate precautions.

´  Rooming in facilitates breast feeding and bonding.

´  Take precautions if your newborn is rooming-in with you.

 

If you are in isolation for Covid-19 and are sharing a room with your newborn.

´  Take the following steps to reduce the risk of spreading the virus to your newborn

´  Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

´  Wear a mask when within 6 feet of your newborn.

´  Keep your newborn more than 6 feet away from you as much as possible.

´  Once the isolation period ends continue with hand washing but other precautions are not required.

 

Effects of the pandemic on the birth experiences of the pregnant women and families

´  Wearing a mask is uncomfortable in pregnancy.

´  Isolation due to social distancing and lack of social interactions – mental health issues.

´  Hospital experience is a little different, lots of infection prevention measures in place. No visitor policy and minimal support persons allowed with you.

´  Limited physical supports, number of people coming into your house to support you is less.

´  Impact on everyday activities, in general extra work involved in taking safety precautions.

 

Hope you find this useful. You are welcome to leave me questions about this if you had any. I will try to address them to the best of my ability.

 

Continue to take action that boost your physical and mental health. Here is a link to exercise at home for pregnant women.

https://www.niagararegion.ca/living/health_wellness/workplace/pdf/PARC-ActivePregnancy.pdf

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