PhD Defense: Never waste a good crisis; Real-World Evidence on the Safety of Medication Use and Vaccination During Pregnancy

The COVID-19 pandemic has had a major global impact, especially on vulnerable groups such as pregnant women. Despite their increased risk of severe illness, pregnant women rarely participated in research on COVID-19 treatments. This dissertation aims to provide insight into the safety of COVID-19 medication use during pregnancy.

One key finding is that pregnant women used remarkably little COVID-19-related medication. Even among severely ill pregnant patients in the hospital, not all women received appropriate treatment, which may have led to an increased risk of complications such as preterm birth and cesarean section. This highlights the need for clear treatment guidelines and better access to medication for pregnant women.

This limited medication use reflects a broader challenge: concerns about safety and a lack of research also play a major role in vaccination during pregnancy. Because few large randomized studies have been conducted in pregnant women, there is significant uncertainty about the safety of vaccines. However, an increasing number of large studies using real-world data show that many vaccines are effective and safe. Still, many pregnant women hesitate to get vaccinated, mainly due to fears about risks for their unborn child.

This dissertation highlights the importance of international collaboration and how we can better use real-world data. It advocates for improved research infrastructure, harmonized data, and clear communication to help healthcare providers and pregnant women make better-informed decisions.