The Bottom Line

This pages serves to highlight the latest objective research, news, and professional guidance and recommendations regarding pregnancy-related health. Unless ongoing, highlights are kept on this page for approximately 30 days before being removed or added to a permanent Topic page.

Recent research updates, health organizational recommendations, and other important highlights related to pregnancy are listed below. Women should talk to their health care provider (HCP) if they have any questions. Full study links are available under "References" at the bottom of the page.

Note: This page will also highlight COVID-19 infection and vaccine-safety data as it is published/released so you can always stay updated.

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Latest Research/Recommendations

The dates below reflect the date of the publication, not the date of page entry.

May 15, 2022: May 15 is International Hyperemesis Gravidarum (HG) Awareness Day. HG is defined as a potentially life-threatening pregnancy disease that may cause weight loss, malnutrition, dehydration, and debility due to severe nausea and/or vomiting, and may cause long-term health issues for mother and baby(ies). Learn more (our HG page) or visit hyperemesis.org.

May 12, 2022 Formula UPDATE: Similac, Alimentum, and EleCare baby formula products have been recalled and should not be used. The U.S. Food and Drug Administration (FDA) is investigating consumer complaints of bacterial infections in four infants who consumed powdered infant formula produced in Abbott Nutrition’s facility in Sturgis, Michigan. The FDA has published a full list of recalled brands. Learn more.

May 6, 2022: Butyrylcholinesterase (BChE), measured in dried blood spots taken 2-3 days after birth, was lower in babies who subsequently died of Sudden Infant Death Syndrome (SIDS) compared to surviving controls and other Non-SIDS deaths. If these results are corroborated in further studies, BChE could be used as a biomarker to identify infants at risk for SIDS.

May 5, 2022: In women with a prolonged second stage of labor, the extended duration did not affect the risk of anal incontinence at 1–2 years after delivery. An extended duration of a prolonged second stage should therefore not be an indication to expedite delivery. Vacuum extraction and especially OASIS (obstetric anal sphincter injuries) after a prolonged second stage were associated with anal incontinence. According to the study authors, care should be taken to avoid OASIS and if several risk factors count up, cesarean section is preferable to avoid anal incontinence.

May 4, 2022: Published review discusses in detail the current management of heartburn in pregnant and breastfeeding women. Management involves lifestyle or dietary modifications first, followed by non-pharmaceutical remedies and pharmaceutical drugs. Management should be individualized and women should speak with their health care provider before taking any medications, including over-the-counter. Read more.

May 2, 2022: Researchers believe they have determined what estriol does during pregnancy. Estriol appears to improve development of the fetal reproductive system and brain. Estriol levels dramatically increase during pregnancy, but prior to this study, scientists believed estriol was relatively inactive, with no major, obvious role in pregnancy.

April 30, 2022: A randomized clinical trial on preventing hemorrhoids during pregnancy found that dietary changes work. Eating meals at regular intervals, drinking plenty of water, eating foods rich in fiber, avoiding foods that cause constipation, and walking regularly can help prevent hemorrhoids during pregnancy and in the postpartum period.

April 29, 2022: Hypertensive disorders in pregnancy (HDPs) (high blood pressure disorders) are common pregnancy complications and leading causes of pregnancy-related death in the United States. During 2017–2019, HDP prevalence among delivery hospitalizations in the increased from 13.3% to 15.9%. Among deaths occurring during delivery hospitalization, 31.6% had a diagnosis code for HDP documented. Learn more about how the cardiovascular system is affected during pregnancy.

April 26, 2022: Stress urinary incontinence (SUI) (leaking urine) is a highly prevalent condition during pregnancy, affecting the quality of life of women in many areas. The presence and severity of SUI during pregnancy are risk factors for the persistence of symptoms six months postpartum. Sustaining an optimal pelvic floor muscle strength could prevent SUI during pregnancy. Learn more.

April 26, 2022: Prenatal alcohol exposure appears to disturb the expression of placental genes resulting in temporary impairment of umbilical cord blood flow and, subsequently, intrauterine growth restriction. Learn more about the effects of alcohol during pregnancy.

April 25, 2022: Ectopic pregnancy results in an urgent, sometimes life-threatening condition and always leads to pregnancy loss. A recent study showed that the level of anxiety, depression, posttraumatic stress, and grief was high among women who experienced ectopic pregnancy. Women should seek counseling as part of the early healing process after ectopic pregnancy.

April 21, 2022: Sudden episodes of increased fetal movement do not seem to be associated with adverse neonatal outcomes or umbilical cord complications. Learn more about both increased and decreased fetal movement.

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COVID-19 Infection and Vaccination

Infection

View our full page on COVID-19 infection and pregnancy.

May 4, 2022: Congenital viral infections are believed to damage the developing neonatal brain. According to a study that assessed possible neurological damage to infants after prenatal COVID-19 exposure, "Infants prenatally exposed to SARS-CoV-2 appear to have a risk of developing along a spectrum from possible serious neurological disorders to minor neurological disorders to a less-than-perfect optimal performance, which should be confirmed in follow-up research. Timely implementation of follow-up programs for infants exposed to SARS-CoV-2 prenatally is urgently needed to identify children at risk."

April 28, 2022: In this study, hospitalized pregnant patients who received monoclonal antibodies due to COVID-19 had favorable outcomes, but further research is recommended to fully assess safety and efficacy of monoclonal antibody treatment in pregnancy. To read additional studies on monoclonal antibody treatment in pregnancy for COVID-19, click here.

March 28, 2022: According to the U.S. Centers for Disease Control (CDC) and Prevention SET-NET surveillance program, of 6,551 infected pregnant women/individuals in this analysis, 142 (2.2%) had positive RNA tests more than 90 days and up to 416 days after infection. While re-infection could not be ruled out, this study illustrates that symptomatic COVID-19 infections might be recurrently positive for up to 416 days after symptom onset in pregnant women/individuals.

General COVID-19 information and pregnancy health: According to currently available case series and cohorts as of May 2022, data indicates pregnant women are not more susceptible to the disease than non-pregnant women, and fetal and symptomatic neonatal infection appear to be rare events.

However, pregnant women who contract COVID-19 appear to be at higher risk of complications from the disease than non-pregnant women of reproductive age. These complications include Intensive Care Unit admission, the need for mechanical ventilation, and the need for extracorporeal membrane oxygenation (ECMO). Learn more.

Weekly COVID-19 Pregnancy Data from CDC:

  • Total Cases: 207,793

  • Hospitalized: 32,718 (data only available for 166,459)

  • Total Deaths: 296

*As of May 9, 2022

These numbers likely do not include all pregnant women with COVID-19 in the United States and must be interpreted with caution.

Vaccination

View our full page on COVID-19 vaccination and pregnancy.

There are currently three COVID-19 vaccines in the United States approved or authorized for use: Comirnaty (formerly known as Pfizer-BioNTech), Moderna (SpikeVax in Canada, Europe), and Johnson & Johnson/Janssen.

May 2, 2022: Sixty-four pregnant women were included and were compared to a control group of 64 non-pregnant women. "Our results show that there were no additional early adverse events in pregnant compared with non-pregnant women. Short-term obstetric complications in pregnant women were negligible."

April 22, 2022: Among 71745 individuals in the CDC's Vaccine Safety Datalink (VSD) who were pregnant during the week ending on February 26, 2022, 49072 (68.4%) were fully vaccinated. Among those who were fully vaccinated, 24321 (49.6%) had received a booster dose. Among pregnant individuals who received a booster dose, 10.9% received it before pregnancy and 89.1% during pregnancy.

April 4, 2022: New findings suggest that COVID-19 vaccination during early pregnancy is not associated with an increased risk of structural birth defects identified using ultrasound imaging.

March 31, 2022: New findings suggest that mRNA vaccines do not reach significant concentrations in the placenta given the absence of definitive COVID-19 Spike protein accumulation in placental tissue. This observation provides evidence supporting the safety of mRNA vaccines to the fetus and placenta.

Photo by Mufid Majnun on Unsplash

MORE: Read more on COVID-19, pregnancy, and more detailed vaccine information and guidance from the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, the Society of Obstetricians and Gynecologists' of Canada, the U.K. Royal College of Obstetricians and Gynaecologists, and The Royal Australian and New Zealand College of Obstetricians and Gynaecologists here.

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Seasonal Allergies

"Rhinitis" (stuffy nose) is the medical term for inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose and stuffiness and usually caused by the common cold or a seasonal allergy.

Allergic rhinitis during pregnancy is the phrase used for nasal congestion from seasonal allergies that occurs during pregnancy. Women with nasal symptoms due to allergies during pregnancy will also have a runny nose, itching, and sneezing.

Nasal congestion caused by allergies can, in general, be made more severe during pregnancy, with potential mental health consequences due to a significant adverse impact to quality of life. Allergies can worse nasal congestion that already occurs as a result of pregnancy. Learn more.

Recent research regarding seasonal allergies and pregnancy:

March 25, 2022: Study demonstrated that pregnant women with allergic rhinitis (nasal congestion due to allergies) showed a significantly lower blood level of vitamin E compared to pregnant women without allergic rhinitis. It is possible that adequate vitamin E may positively impact the development of allergic rhinitis, but more research is necessary. Supplementation outside of deficiency is not recommended during pregnancy until evidence increases regarding its benefits.

November 15, 2021: Allergic rhinitis during pregnancy was independently and significantly associated with an approximately 50% increased risk of postpartum depression among women giving birth.

Action

Women should talk to their HCP if they any questions related to any of the updates or research findings above.

COVID-19: Not all pregnant women who contract COVID-19 (or other respiratory infections) will have serious illness. However, there is currently no way to determine which women may experience a more severe course of infection.

It is recommended that pregnant women:

  • Seek care immediately or dial 911 if experiencing a medical emergency. Emergency symptoms can include trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, or bluish lips or face. This is not an inclusive list, and women should always call their HCP or visit an emergency room when necessary.

  • Report any and all symptoms of a respiratory infection to their HCP, to include cough, fevershortness of breath, and diarrhea

  • Wear a mask in public settings in communities with high transmission

  • Regularly wash hands for at least 20 seconds (if soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol)

  • Avoid touching their eyes, nose, and mouth with unwashed hands

  • Do not skip prenatal care appointments or other health appointments that may be necessary

  • Make sure to have at least a 30-day supply of prescription medications

  • Learn about stress and coping

  • Get adequate sleep and physical exercise

  • Quit smoking (risk factor for infection)

Any pregnant woman who has traveled in a state or country with a high rate of COVID-19 infection or who has had close contact with an individual with confirmed infection should be tested and quarantined.

Pregnant women are also advised to see their HCP immediately or call 911 if they experience:

  • Difficulty breathing or shortness of breath

  • Persistent pain or pressure in the chest or abdomen

  • Persistent dizziness, confusion, inability to arouse

  • Seizures

  • Not urinating

  • Severe muscle pain and/or weakness

  • Fever or cough that improves but then returns or worsens (may indicate pneumonia)

  • High fever that is not responding to acetaminophen or other anti-fever medication (acetaminophen is not an NSAID)

Women should refer to the CDC and ACOG COVID-19 web pages below for additional information.

Resources

Total cases in the United States/COVID tracker (U.S. Centers for Disease Control and Prevention)

COVID-19 Home Page (U.S. Centers for Disease Control and Prevention)

ACOG Statement on COVID-19 and Pregnancy (American College of Obstetricians and Gynecologists; June 2020)

Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients (American College of Obstetricians and Gynecologists)

The Management of Respiratory Infections During Pregnancy (Immunology and Allergy Clinics of North America; 2006)

References

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