Making safety judgments for two is a daunting responsibility during pregnancy. During the COVID-19 pandemic, concern has understandably included questions about vaccination against this new viral threat.

Last week, Nature, a highly respected journal, published a systematic analysis of multiple medical studies. The resulting article is a powerful yet accessible shareable database of the accumulated science, with data overwhelmingly supporting vaccination. The evidence evaluated 23 studies that included 117,552 vaccinated pregnant women, who "almost exclusively" received mRNA vaccines, meaning either Moderna or Pfizer.

The two-shot series offered impressive protection against infection — close to 90% in the time window studied. In addition, the review found "no evidence of a higher risk" of adverse outcomes such as:

— Miscarriage.

— Premature birth.

— A lower birthweight score.

— Pulmonary embolism.

— Placental abruption, a severe condition that can reduce fetal oxygen and nutrients.

— Stillbirth.

The authors do not hesitate to draw broader conclusions to guide doctors and pregnant women. "This provides further evidence that the risks of COVID-19 outweigh the rare risks of vaccination in pregnancy, and pregnant people should be encouraged to pursue vaccination, even in the first trimester,'' they write.

The virus is a particular health threat during pregnancy. "Among women of reproductive age with COVID-19, pregnant women are more likely to be hospitalized and at increased risk for ICU admission and receipt of mechanical ventilation compared with nonpregnant women," according to a report from the U.S. Centers for Disease Control and Prevention.

Dr. Sarah Cross, an assistant professor of obstetrics, gynecology and women's health at the University of Minnesota Medical School, reviewed the Nature analysis and pointed out the data's striking consistency — "across the board" favorability. She tells expecting patients that the "most important thing for the baby is for you to be healthy." The COVID-19 vaccination, Cross said, is "how you keep yourself healthy."

For those who still have questions, seek out a medical provider. Said Cross: "We want to talk to you. We want to help you be safe. Just ask us."