ExportAsFixedFormat xlTypePDF not giving same results as native PDF export

I have a workbook that I'm using RDBMailPDFOutlook to email certain sheets. If I save as a PDF in Excel, the pages look correct. When I use theExportAsFixedFormat PDF, I get extra pages like the margins are messed up. I do have pictures inserted on the sheet...not sure if that may be causing an issue or not. Has anyone had this issue with this?

Thanks