During pregnancy, “Lots of aspects of your physiology are kind of maxed out ... operating at the edge of what your body can do.” Adding an infection with SARS-CoV-2 can push the body over that edge.
The risks from developing COVID-19 when pregnant and unvaccinated were demonstrated again in a recent study from Scotland. From December 2020 until the end of October 2021, a period when vaccines were available, there were 4,950 confirmed coronavirus infections among pregnant women. Seventy-seven percent occurred in those unvaccinated, along withBabies suffered too. The death rate for babies born within 28 days of their mother’s COVID-19 diagnosis was 22.
That risk is tied to changes in the immune system. “Pregnancy is a very complicated immune state,” says Andrea Edlow, a maternal-fetal medicine specialist at Massachusetts General Hospital and Harvard Medical School in Boston. The immune system needs to defend pregnant individuals and their fetuses against pathogens. But certain immune system players are somewhat suppressed in order to tolerate pregnancy, something that is half self and half non-self.
Some clues have emerged as to why the delta variant raised the stakes. With the original SARS-CoV-2 and the early variants, pregnant individuals rarely had detectable virus in their bloodstream during an infection, Edlow says. It was also uncommon for the placenta to be infected, and even rarer for the virus to spread to the fetus, she says.
Getting vaccinated against COVID-19 when pregnant also appears to protect the baby, as the post-shot antibodies can cross the placenta. For example, a study from November of 2021 analyzed umbilical cord blood from 36 pregnancies during which the moms had gotten shots. All ofAmerican Journal of Obstetrics and Gynecology Maternal-Fetal MedicineAnd the antibodies are also found in the breastmilk of those vaccinated while nursing, several studies have found.
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