Contemporary OB/GYN week in review: COVID vaccine knowledge, low fertility, and more

This week at Contemporary OB/GYN®, we covered topics ranging from reduced knowledge about COVID-19 vaccination in pregnancy to generic mifepristone's FDA approval. Click the links below to read anything you might have missed from Monday, September 29, to Friday, October 03, 2025.

Low awareness of COVID-19 vaccine safety in pregnancy reported

The need for COVID-19 vaccination during pregnancy has been unrecognized by over half of US adults, according to a recent study by the University of Pennsylvania.

Only 38% of survey respondents indicated they would recommend pregnant patients receive the COVID-19 vaccine, and less women than men expressed belief that the vaccine is safe during pregnancy. This highlighted increasing controversy about vaccination use to protect pregnant women and their infants following updated recommendations in May 2025.

“Even though those in charge of the CDC have withdrawn its support for COVID-19 vaccination during pregnancy, the science showing the value of that vaccination has not changed,” said Kathleen Hall Jamieson, PhD, Annenberg Public Policy Center director.

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Kenneth M. Johnson, PhD, highlights record low US fertility rates

In a recent interview with Contemporary OB/GYN, Kenneth M. Johnson, PhD, professor of sociology at the University of New Hampshire, discussed his study on fertility patterns in the United States, highlighting a historic decline in birth rates with wide-reaching implications for society.

According to Johnson, the US fertility rate is currently at its lowest level ever recorded, with a 22% drop since 2007, just before the Great Recession. In 2007, there were approximately 4.3 million births, compared with only 3.6 million last year, despite the fact that the population of women in their prime childbearing years has increased by approximately 12%. Johnson noted that, had pre-recession fertility patterns persisted, the nation would likely have seen around 1 million more births last year alone.

FDA approves generic mifepristone tablet for abortion

On October 2, 2025, FDA approved the first generic version of mifepristone tablets, 200 mg, submitted by Evita Solutions, LLC. The approval, issued under an Abbreviated New Drug Application in 2021, confirms the product is bioequivalent and therapeutically equivalent to Mifeprex (mifepristone) 200 mg, marketed by Danco Laboratories.

Mifepristone, in combination with misoprostol, is indicated for the medical termination of intrauterine pregnancy through 70 days of gestation. The generic version will be subject to the existing Mifepristone Risk Evaluation and Mitigation Strategy Program, a single, shared system that includes Elements to Assure Safe Use and an implementation system.

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Menopause not linked to worsening disability in women with MS

Researchers from Monash University have found that there is no link between menopause and increased disability risk in women with multiple sclerosis (MS), publishing their findings in JAMA Neurology.

According to Francesca Bridge, PhD, neurologist at Alfred health, these results can reassure women transitioning into menopause and their doctors that the transition will not worsen their MS symptoms. This can be used to guide symptom management decisions, such as menopausal hormonal therapy use and lifestyle modifications.

“Women with MS will benefit from the holistic management of menopausal symptoms with lifestyle measures such as exercise and maintaining a healthy diet, as well as pharmacological measures,” said Bridge.

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Preconception BMI drives fertility struggles and miscarriage risk

Preconception body mass index (BMI) outside of the normal category in men and women is associated with time to pregnancy and miscarriage, according to a recent study published in JAMA Network Open.

A decrease in fecundability was identified for every unit increase in BMI among both women and men, with a fecundability ratio (FR) of 0.98 for the former and 0.99 for the latter. Additionally, an FR of 0.88 was reported for overweight vs normal weight status, alongside 0.72 for obesity vs normal weight.

In men, overweight and obesity also decreased fecundability, with an FR of 0.89. Women and men also reported FRs of 1.04 and 1.03, respectively, for subfertility with increased BMI. The FRS for subfertility among women with underweight, overweight, and obesity vs normal weight were 1.88, 1.35, and 1.67, respectively.

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