COVID-19 vaccine does not appear to damage placenta

Pregnant women who received the COVID-19 vaccine did not have more placental damage than unvaccinated pregnant women, according to researchers.

The findings support the safety of COVID-19 vaccination during pregnancy, Jeffery Goldstein, MD, PhD, an assistant professor of pathology at Northwestern University Feinberg School of Medicine and a pathologist at Northwestern Medicine, and colleagues wrote in Obstetrics & Gynecology.

“The placenta is like the black box in an airplane. If something goes wrong with a pregnancy, we usually see changes in the placenta that can help us figure out what happened,” Goldstein said in a press release. “From what we can tell, the COVID-19 vaccine does not damage the placenta.”

Goldstein and colleagues conducted a cohort study comparing the placentas of 84 pregnant women (maternal age, 33.7 years) who delivered between January and April, tested negative for SARS-CoV-2 and received the COVID-19 vaccine, and a control group of 116 women (maternal age, 32.5 years) who delivered between April 2020 and April 2021, tested negative and did not receive the vaccine.

Women who were vaccinated had “robust antibody responses,” according to Goldstein and colleagues. Anti-SARS-CoV-2 signal/cutoff ratios were higher in this group for both IgG (22.8 vs. 0.04, P < .001) and IgM (4.1 vs. 0.19, P = .001).

There was no increased incidence of decidual arteriopathy (adjusted OR [aOR] = 0.75; 95% CI, 0.3-1.9), fetal vascular malperfusion (aOR = 0.85; 95% CI, 0.27-2.7), low-grade chronic villitis (aOR = 1.6; 95% CI, 0.62-4.2) or chronic histiocytic intervillositis in the placentas of vaccinated vs. unvaccinated women, according to the researchers. More women in the control group had high-grade chronic villitis than in the vaccine group (16 vs. 4).

“We are beginning to move to a framework of protecting fetuses through vaccination, rather than from vaccination,” Emily Miller, MD, MPH, a maternal-fetal medicine physician and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, said in the press release. “Our team hopes these data, albeit preliminary, can reduce concerns about the risk of the vaccine to the pregnancy.”

References:

• Goldstein JA, et al. Obstet Gynecol. 2021;doi:10.1097/AOG.0000000000004457.
• Northwestern University. COVID-19 vaccine does not damage the placenta in pregnancy. Accessed May 18, 2021. Available at: https://news.northwestern.edu/stories/2021/05/covid-19-vaccine-does-not-damage-the-placenta/.