COVID vaccination during pregnancy does not increase risk of spontaneous abortion

A research letter in JAMA has concluded that the risk of spontaneous abortion is not increased by COVID-19 vaccine exposure in the 28 days prior to spontaneous abortion compared to women with ongoing pregnancies.

“This study is part of our work with the Vaccine Safety Data link, a collaboration between the Centers for Disease Control and Prevention (CDC) and 9 health systems, which monitors the safety of COVID-19 vaccines in pregnancy,” said principal investigator Elyse O. Kharbanda, MD, MPH, a senior research investigator at Health Partners Institute in Minneapolis, Minnesota.

Spontaneous abortion is an important outcome in studies of maternal vaccine safety because of concerns that risks of it may be a barrier to vaccination during pregnancy.

The study analyzed data from 8 health systems, located in Washington state, California, Colorado, Minnesota, Oregon, and Wisconsin, over 7 4-week surveillance periods between December 2020 and June 2021.

Ongoing pregnancies between 6 and 19 weeks’ gestation were recorded on the last day of each 4-week surveillance period (index date), whereas spontaneous abortions were assigned to a 4-week surveillance period based on their outcome date.

Among 105,446 unique pregnancies, 13,160 spontaneous abortions and 92,286 ongoing pregnancies occurred.

During pregnancy and before 20 weeks’ gestation, 7.8% of women received 1 or more BNT162b2 (Pfizer-BioNTech) vaccines; 6% received 1 or more mRNA1273 (Moderna) vaccines; and 0.5% received an Ad26.COV.2.S (Janssen) vaccine.

A COVID-19 vaccine was received within 28 days prior to an index date in 8% of ongoing pregnancies compared to 8.6% of spontaneous abortions.

Spontaneous abortions were not associated with increased odds of exposure to a COVID-19 vaccination in the prior 28 days versus ongoing pregnancies: adjusted odds ratio (aOR) = 1.02; 95% confidence interval (CI): 0.96 to 1.08.

“There is not a clear biologic mechanism for vaccines, including the mRNA COVID-19 vaccines, to increase risk for spontaneous abortion,” Kharbanda told Contemporary OB/GYNÒ. “Prior studies of inadvertent human papillomavirus (HPV) vaccination and flu vaccination have also demonstrated the safety of these vaccines when administered in first trimester.”

Furthermore, the current findings are consistent with data from other sources, including self-reports of spontaneous abortions following COVID-19 vaccine, as reported to the V-Safe registry, according to Kharbanda.

“Pregnant women and providers should feel reassured that in our study of over 100,000 pregnancies, the COVID-19 vaccines were not associated with increased risks for spontaneous abortion,” Kharbanda said. “The findings add to the evidence supporting the safety of these vaccines in pregnancy.”

Still, there are several notable limitations to the study, including that the gestational age of spontaneous abortions and ongoing pregnancies were not chart confirmed; also, pregnancy dating could be inaccurate early in pregnancy.

“Moreover, although vaccination status was identified using multiple data sources, the COVID-19 vaccine rollout has been complex and some vaccines may have been missed, potentially biasing findings to the null,” Kharbanda said.

Similarly, data on important confounders like prior pregnancy history were not available; likewise, it was not possible to assess risks specific to the Ad26.COV.2.S vaccine, due to the small number of exposures.

 

This article was originally posted on Medical Economics®.

 

INTERPRETATION OF SEROLOGIC TESTING IN PATIENTS WITH Hepatitis B Virus INFECTION.

 

Things to Avoid During Pregnancy

While most women can keep up their daily routine during pregnancy, some activities—and certain foods—should be avoided. A healthcare practitioner can offer expert advice based on your unique circumstances. Generally speaking, however, here are five key things to avoid when pregnant:

    1.Certain foods, caffeine, and alcohol

    Pregnant women may experience a change in their sense of smell and even feel nauseous around certain foods. These types of symptoms are especially prevalent during the first trimester. But ultimately, regardless of the symptoms you experience, you’ll want to avoid the following foods and beverages:

a.       Unpasteurized dairy and juices

    Unpasteurized (or raw) dairy products, including soft cheeses like Brie and Camembert, may be contaminated with Listeria or other bacteria linked to food-borne illness. Unpasteurized juices should be avoided for this same reason.

b.       Raw eggs

    Raw eggs may contain harmful bacteria like Salmonella., Be sure to cook your eggs until both the whites and the yolks are firm., Be leery of foods made with raw or undercooked eggs, including eggnog, cookie dough, and Caesar salad dressing.,

c.       Raw meat and fish

    From steak tartare to sushi to raw oysters, pregnant women should steer clear of raw meat and fish. These items may contain Salmonella and Toxoplasma—pathogens associated with food poisoning—which can cause fever, dehydration, and other conditions that are especially dangerous during pregnancy.

    Pregnant women should also avoid cooked fish that feature high mercury levels, including swordfish, mackerel, and tuna. Exposing the foetus to too much mercury can cause neurological, vision, and hearing issues.

d.       Deli meats

Deli meats and preprepared deli salads should also be avoided during pregnancy. Like unpasteurized dairy and juices, they are more likely to contain Listeria than many other food items.

    e.    Caffeine

Pregnant women need not forego their morning coffee entirely—limiting caffeine intake, on the other hand, is crucial. Research indicates that expecting mothers should limit their caffeine intake to 00 milligrams per day, which translates to three -ounce cups. Quantities that exceed this amount can be harmful to the foetus, so mothers-to-be must exercise caution when drinking coffee or caffeinated tea.

e.       Alcohol

Unlike caffeine, alcohol should be completely avoided during pregnancy. This is because when an expecting mother drinks, the alcohol comes in contact with the placenta and can cause issues like foetal alcohol syndrome.

 

Researchers have limited information on how much alcohol is too much during pregnancy. This means you must put your drinking on hold until you deliver your child—or, if you plan on breastfeeding, until you stop nursing your infant.

2. Certain medications

Certain over-the-counter and prescription drugs, along with many herbal remedies, may be harmful to the foetus. Most medical professionals suggest avoiding the following medications during pregnancy:

    Most cold medications during the first semester in particular

    Cold and flu medications that contain specific potentially harmful ingredients

    Certain acne medications

    Angiotensin-converting enzyme (ACE) inhibitors or medications that widen the blood vessels

    Ibuprofen and a number of other nonsteroidal anti-inflammatory drugs (NSAIDs)

Please note that your doctor may suggest avoiding other medications than those listed above. A physician or pharmacist can offer additional guidance and alternative recommendations as needed.

3. Hot tubs and saunas

Expecting mother’s ought to avoid hot tubs, saunas, and steam rooms until they give birth. These warm spaces can cause hyperthermia—the opposite of hypothermia—or exceedingly high body temperature.

Hyperthermia is linked to a number of congenital abnormalities, so experts highly recommend that pregnant women avoid overheating in general. While there’s no need to completely eliminate sweat-inducing activities from your life, you will want to be mindful while engaging in hot yoga, sunbathing, and other forms of strenuous exercise.

If you are going to engage in a strenuous activity or spend time in extreme heat, be sure to drink plenty of water. Staying hydrated can help you maintain a lower body temperature.

4. Litter boxes

    Cat owners, listen up: Expecting mothers are welcome to continue caring for their beloved pets—but they should avoid changing litter boxes until their baby arrives.

    What’s wrong with litter boxes? Cleaning dirty litter boxes presents a risk of Toxoplasma exposure, which is especially harmful for pregnant women. The Centers for Disease Control and Prevention states that passing Toxoplasma to the fetus can result in severe birth defects ranging from intellectual challenges to brain or eye damage.

    To promote good health during this time in your life, simply ask a trusted friend or partner to take on the litter box responsibilities until the birth of your child.

5. Contact sports, heavy lifting, and other higher-risk physical activities

    If you’re pregnant, contact sports like football and hockey are a no-go. Specifically, these forms of exercise increase one’s risk of placental abruption—that is, the early separation of the placenta from the uterine wall. Placental abruption is linked to several severe conditions, so you’ll want to focus on gentler forms of exercise until you deliver your baby.

    Pregnant women should also avoid lifting heavy objects. Hormonal changes during pregnancy may cause the ligaments to loosen, which makes expecting mothers more prone to injuries like pulled muscles, hernias, and more.

    In brief, with the exception of those facing critical health issues, expecting mothers are encouraged to get plenty of physical activity. Certain types of physical activity, however, should be avoided. Specifically, activities that include the following ought to be blacklisted until childbirth:

    Sharp movements or sudden changes in direction

    Activities with a high risk of falling like ice skating or horseback riding

    Bouncing or jumping

    Abdominal exercises like situps or bicycle kicks after the first trimester

    While it may sound like your options are limited, most exercises—including hiking, swimming, and squats—are highly beneficial during pregnancy., Simply contact your doctor if you have questions involving what’s acceptable.

 

KNOW ABOUT VAGINA

 

With all the progress being made in the world today, sexual health is still an uncomfortable topic to talk about. Doubts lead us to friends first and then to Google and then to a cycle of information that may or may not be true. Despite what Google says — the hymen doesn’t grow back if you don’t have sex for a long time!

Our culture of considering sex and sexuality as dirty and shameful creates a negative environment for young people where they cannot talk about it openly.

Vaginal Discharge is normal.

Yes, everyone has it, and it is normal. Healthy discharge can be clear or white depending upon your cycle. The consistency can change throughout your menstrual cycle.

Vaginal odour is normal.

It is not normal for your vagina to smell like flowers so stop trying to make that happen with douches and deodorants. A slight odour that isn’t strong smelling is normal.

The Vagina is self-cleansing.

Yes, it is. So, there is no need to wash five times a day down there. The vagina uses natural secretion and discharge to clean itself and prevent infections.

It is not necessary to wear underwear 24/7.

Underwear can trap excess moisture and microbes. Other than comfort, not wearing underwear can prevent the build-up of heat and moisture, which can increase the risk of infection. It is ok to go commando! Let her breathe once in a while.

Always choose cotton underwear.

Cotton is more breathable, making it best for body parts that tend to lock in moisture. Regularly wearing silk and lace underwear can cause irritation.

Bleached patches on your underwear are normal.

The vaginal discharge is naturally acidic. When exposed to air, it can stain underwear a mild yellow due to oxidation.

Fungal infections are more common than you think.

About 75% of all women will have a yeast infection at least once in their lifetime. Do not hesitate to consult a doctor in case of itching, soreness, burning while urinating or pain during sex.

Douches and perfumes are a NO.

You don’t need any special products to clean unless your doctor tells you otherwise. Douches and perfumes can cause irritation, alter the pH, and can worsen infections.

And never use soaps inside the vaginal cavity.

 

The vagina is an internal cavity, not the entire genital area. What you see outside is the vulva. Please do not use soaps inside your vagina.

You can do a perineal workout.

Yep. Kegels can strengthen the muscles around the vaginal opening. Stronger muscles can help to recover early! Quite helpful after a normal delivery.

Always urinate after sex.

This helps the urethra to cleanse itself, reducing the chances of developing a urinary tract infection.

Is the G-spot real?

This is still a topic for debate. While researchers search for this mythical spot, why not concentrate on the clitoris instead? It has more than 8000 nerve endings, and according to scientists, its sole purpose is sexual pleasure.

You can’t lose a tampon- or anything- in your vagina.

At the deep end of your vagina is a cervix. It stays closed all the time except during childbirth. So you can’t really lose anything in there.

The hymen is not an indicator of virginity.

The hymen can break during many activities like horse-riding, riding your bike, or playing sports. A ruptured hymen is normal. According to the World Health Organization, there is no test- including the presence of an intact hymen- that can indicate whether a woman has had sex.

Your pubes have a purpose.

Pubic hair serves as a protective barrier to genital tissues, especially the sensitive vaginal opening. It also acts as a buffer against friction. Shaving can cause tiny wounds on the skin, temporarily raising one’s risk of infection.

Your vagina is set at a 130-degree angle.

The vaginal canal rests at an angle in the body, which is why it is recommended to insert tampons and menstrual cups towards your back rather than up and in for easier insertion.

Your vagina will let you know when you are fertile.

The discharge will be clear an stretchy during ovulation. You may also notice more than usual discharge during this time. Do not rely on mucous monitoring alone for pregnancy prevention. It is not always reliable.

Your vagina will also let you know if something is wrong.

Any changes in smell or colour of discharge can be an indication of infection requiring a visit to a doctor.

There is so much that we don’t know about our own bodies. We owe it to ourselves to learn more. There is also a lot of embarrassment around vaginas. Share the right knowledge and be the wise woman that you are.