Vaccines: COVID-19 infections are more severe in pregnant women compared to their nonpregnant peers, resulting in greater hospital admissions, intensive care unit stays, and death (Gray et al., 2021). As of March 1, 2021, more than 80 maternal deaths and over 73,600 COVID-19 infections occurred in pregnant women in the United States. Despite these numbers, pregnant women were excluded from the initial COVID-19 vaccine trials. It was not until February 2021 that the first vaccine trials in pregnant women began. Gray et al. reviewed the results of the COVID-19 vaccine on 131 reproductive age women, including 84 who were pregnant, 31 lactating, and 16 nonpregnant. Results indicated that the COVID-19 messenger RNA vaccines generated immunity in pregnant and lactating women similar to that observed in nonpregnant women. Additionally, immunity transferred to the neonates via placenta and breastmilk. Mithal et al. (2021) reported that pregnant women who were vaccinated for COVID-19 earlier in their third trimester had a higher likelihood of passing protective antibodies to their newborns than women who received their vaccine closer to delivery.
Additionally, Shanes et al. (2021) reviewed the findings of 84 women who received a COVID-19 vaccine during pregnancy and 116 women in a control group who did not receive a vaccine. Vaccinated women showed a strong antibody response, and these COVID-19 antibodies were successfully transferred to their fetuses There was also no evidence that the vaccines affected the women's placentas. In contrast, the placentas of 16 women who tested positive for COVID-19 while pregnant showed evidence of injury (Samuelson, 2020). According to pathological exams completed directly following birth, injuries included reduced blood flow from the mother to the fetus due to abnormal blood vessels and blood clots in the placenta. Shanes et al. (2021) concluded that research supports the safety of COVID-19 vaccination in pregnant women without adverse effects for the fetus.
Fetal Alcohol Spectrum Disorder (FASD): During the COVID-19 pandemic, alcohol use increased sharply, and there is evidence that alcohol use among pregnant women also increased (Weir, 2022). Researchers estimate that 2 to 5 percent of U.S. children may be affected by alcohol exposure resulting in behavioral, learning, and mental health disorders. As of July 2022 a bipartisan bill, called the FASD Respect Act, is before Congress. This bill would support FASD research, surveillance, and activities related to diagnosis, prevention and treatment.