COVID-19 Vaccines Reduce, Not Increase, Risk of Stillbirth

SciCheck Digest

There is no link between COVID-19 vaccination and an increased risk of stillbirth, despite such claims online. In fact, vaccination has been shown in multiple studies to reduce the risk of stillbirth by protecting pregnant people and their babies from the coronavirus.

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Numerous studies evaluating the safety of the COVID-19 vaccines in pregnant people have found no increased risk of stillbirth among those who have been vaccinated. Far from demonstrating a safety hazard, vaccination has been shown to reduce a variety of coronavirus-related risks during pregnancy, including stillbirth.

Despite the robust safety findings, online posts have been circulating a “leaked” memo from a Fresno, California, hospital to incorrectly suggest that COVID-19 vaccination increases the risk of stillbirth.

“Leaked Hospital Email Reveals Explosion of Stillbirths Following COVID Vaccine Rollout,” reads one headline from the conspiracy theory website InfoWars, which was shared on Instagram.

The claim appears to originate with an Oct. 24 story in the Epoch Times, a far-right outlet affiliated with the Chinese spiritual movement Falun Gong. The site is frequently a source of misinformation, including on COVID-19 and vaccines.

According to the Epoch Times story, a staff member at a Fresno hospital claimed that the stillbirth rate had “skyrocketed” after the COVID-19 vaccine rollout. The employee shared an email from a managing nurse on Sept. 8 that referred to an apparent uptick in the number of “demise patients” occurring across the hospital system, including 22 demises in August, which tied the record in July 2021.

But the memo makes no mention of COVID-19 vaccination and is primarily focused on informing nursing staff how to properly handle the demise specimens. Moreover, the email never states that its figures are only for stillbirths.

Fetal death, or fetal demise, refers to death at any time in pregnancy. Deaths before 20 weeks of gestation are miscarriages, while deaths after 20 weeks (or sometimes 28 weeks) are considered stillbirths. Conflating stillbirth with fetal death erroneously exaggerates the number of stillbirths.

The public health departments of Fresno County and California also told us there has not been a significant increase in the stillbirth rate since the introduction of COVID-19 vaccines.

Citing Dr. James Thorp, a Florida gynecologist who has spread misinformation about the COVID-19 vaccines before, the Epoch Times proceeded to then falsely claim that the memo was “consistent” with other vaccine safety monitoring data in showing that the vaccines are hazardous during pregnancy.

That’s incorrect. The memo doesn’t implicate the COVID-19 vaccines, nor does the existing evidence suggest that vaccination is unsafe for pregnant people and their fetuses. On the contrary, vaccination can protect against COVID-19, which can be particularly dangerous for pregnant people and raise the risk of pregnancy complications, including stillbirth.

COVID-19 Vaccination Can Protect Against Stillbirth

According to a regularly updated online explainer by Victoria Male, a lecturer in reproductive immunology at Imperial College London, 16 studies have assessed COVID-19 vaccination safety with respect to stillbirth, and none has found an increased risk of stillbirth following COVID-19 vaccination.

A meta-analysis reviewing some of those studies, the explainer notes, “found that COVID vaccination actually reduces the risk of stillbirth,” likely because of the risk posed by coronavirus infection. The meta-analysis, published in Nature Communications in May, found the “risk of stillbirth was significantly lower in the vaccinated cohort by 15%.”

Dr. Brenna Hughes, a maternal-fetal medicine specialist at Duke University Health System who has studied COVID-19 during pregnancy, also directed us to a study published this month in the American Journal of Obstetrics & Gynecology that found vaccinated women in Australia were about 80% less likely to experience a stillbirth compared with unvaccinated women. Hughes told us the claims in the posts were “quite false.”

Numerous studies have found that pregnant people who get infected with the coronavirus, or SARS-CoV-2, have a higher risk of stillbirth and other bad outcomes for both the mother and the baby than those who do not get infected.

A Centers for Disease Control and Prevention study of more than 1.2 million delivery hospitalizations between March 2020 and September 2021, for example, found that American women with COVID-19 had nearly double the risk of a stillbirth compared with those who did not have COVID-19. The risk was more than four times as high when the delta variant was dominant.

A meta-analysis of 111 studies, which included more than 42,000 pregnant women, found that COVID-19 significantly increased the risk of premature delivery, preeclampsia, neonatal death, maternal death and stillbirth. The risk of stillbirth among those with COVID-19 was nearly 2.4 times higher than for women without COVID-19.

Research suggests that among women with COVID-19, it’s infection of the placenta, or what’s called SARS-CoV-2 placentitis, that increases the risk of stillbirth. The placenta is a temporary organ that develops during pregnancy that delivers nutrients and oxygen to the fetus, among other functions.

It’s relatively rare, but as a review published in October in the American Journal of Obstetrics & Gynecology explains, the coronavirus can destroy more than 75% of the placenta, preventing it from providing oxygen and killing the fetus. Some autopsies of stillbirths born to mothers infected with SARS-CoV-2 have shown signs of asphyxia. In most cases, the fetus isn’t directly infected with the virus.

Unlike with many aspects of COVID-19, there doesn’t appear to be a link between COVID-19 severity and stillbirth. Some reported cases of stillbirths with SARS-CoV-2 placentitis have even occurred in pregnant people who were asymptomatic.

Even so, it’s striking that among the SARS-CoV-2 stillbirth cases described in the literature, none has been in a vaccinated mother.

“It seems beyond coincidence that in the multiple reports of SARS-CoV-2 placentitis associated with stillbirths and neonatal deaths, none of the mothers had received COVID-19 vaccinations,” the review notes. “In addition, although not constituting proof, the authors are not aware either personally, via collegial networks, or in the published literature of any cases of SARS-CoV-2 placentitis causing stillbirths among pregnant women who received the COVID-19 vaccine.”

The authors of the review suspect that vaccination likely protects against stillbirth by preventing SARS-CoV-2 from getting into the bloodstream, which is probably how the virus reaches the placenta.

Consistent with the notion that vaccination is effective in reducing the risk of COVID-19-related stillbirth, preliminary v-safe COVID-19 Pregnancy Registry data presented to the CDC’s vaccine advisory committee last month found that pregnant people who were fully vaccinated and contracted the coronavirus did not have a higher risk of stillbirth than their peers who didn’t get infected.

To be clear, the chances of a pregnant person having a stillbirth, even if infected with the coronavirus, is still quite low. According to the CDC, there’s about 1 stillbirth in every 175 births, which would mean it happens less than 0.6% of the time. Doubling or tripling this risk would mean that the risk would still be below 2%.

But if someone is concerned about stillbirth — not to mention all the other maternal and fetal complications of COVID-19 — the evidence shows COVID-19 vaccination would be a good idea, not a bad one, as the posts online suggest.

Fresno Claim

Beyond the overwhelming evidence that COVID-19 vaccination does not cause stillbirths, the details about the alleged increase in Fresno stillbirths also don’t add up.

We reached out to multiple birthing hospitals in the city and were able to identify the hospital system responsible for the memo that was shared with the Epoch Times as Community Medical Centers.

In a statement, the hospital said that the email was about hospital policy, did not include any reference to COVID-19 vaccination — and was not limited to just stillbirths.

“There are a number of reasons for a fetal demise and it can go unexplained in some cases,” Sarah Putman, the director of women & newborn health at Community Regional Medical Center, said. “This was an internal memo from a clinical staff member to others in the unit reminding them to adhere to hospital policy, and thanking them for the time and attention they have provided to patients. The memo writer made a personal observation about all pregnancy losses in the memo that was secondary to reinforcing hospital policies and procedures with staff. There was no mention by that staff member about a cause for this observation, and neither COVID-19 nor vaccines were mentioned.”

The email specifically mentions “demise patients” who died before 20 weeks, which would be miscarriages, not stillbirths. Setting aside the fact that the 22 demises in August mentioned in the memo is not an official figure to start — and is only for a short period of time at a single hospital system — it’s incorrect to calculate a stillbirth rate from the number, as the physician quoted in the Epoch Times article did.

Scientists have much better and more robust data to evaluate whether vaccination increases the risk of stillbirth, and the evidence is clear that it does not.

The claim is also predicated on the idea that there has been a rise in stillbirths over the last two years. While it’s possible that could be the case for the one hospital system — Imperial College London’s Male said that could be due to several reasons, such as an outbreak of certain infectious diseases, changes in prenatal care or random chance — there is no sign of any kind of widespread increase in stillbirths in the area.

The California Department of Public Health told us that as of November 2022, there had been “no significant increase in California stillbirth rates since the introduction of COVID-19 vaccines, and no stillbirth certificate has mentioned ‘COVID-19 Vaccination.’”

An epidemiologist with the Fresno County Department of Public Health told us that was also the case for Fresno, adding that the department has a fetal and infant mortality review team, which has not reviewed a concern about the vaccines.

Given that COVID-19 increases the risk of stillbirth, it’s reasonable to think there might have been an increase in stillbirth rates over the past couple of years. The most recent national data only go up to 2020, and the rate of 5.74 deaths per 1,000 births was not significantly different from the rate of 5.70 in 2019. This fact was mentioned by Thorp in the Epoch Times article, although he cherry-picked a comparison with 2018, when the rate was slightly higher.

Time will tell what the national statistics will look like — the CDC told us the 2021 data would be expected to be released in the summer of 2023, per the usual schedule — but whatever the stillbirth rate is, it won’t mean that COVID-19 isn’t a risk to pregnant people.

Male explained that because stillbirth is quite rare, the additional stillbirths due to COVID-19 might not make that big of an impact on the national numbers. She told us, for example, that in the U.K., there were only 77 COVID-19 stillbirths up through October 2021 — which wasn’t a lot relative to the annual baseline of about 2,500. And because the stillbirth rate in the U.S. is higher than in the U.K., she said, “COVID stillbirths are likely to make even less of an impact” in America.

Again, the data are already clear that COVID-19 increases the risk of stillbirth and vaccination can reduce that risk.

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Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.

Sources

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Prasad, Smriti et al. “Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy.” Nature Communications. 10 May 2022.

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