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Peripartum Outcomes Associated With COVID-19 Vaccination During Pregnancy: A Systematic Review and Meta-analysis

Atsuyuki Watanabe1, Jun Yasuhara2, Masao Iwagami3

  • 1Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.

JAMA Pediatrics
|October 3, 2022
PubMed

Insights

COVID-19 vaccination during pregnancy is safe and recommended. It reduces the risk of neonatal intensive care unit admission, intrauterine fetal death, and maternal SARS-CoV-2 infection, with no increased risk of adverse peripartum outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Public Health

Background:

  • The safety and efficacy of COVID-19 vaccination during pregnancy require further investigation, with limited pooled data on neonatal and maternal outcomes.
  • Evaluating the association between pregnancy COVID-19 vaccination and peripartum outcomes is crucial for informed clinical recommendations.

Purpose of the Study:

  • To assess the impact of COVID-19 vaccination during pregnancy on various neonatal and maternal peripartum outcomes.
  • To synthesize existing evidence on the risks and benefits of maternal COVID-19 vaccination.

Main Methods:

  • A systematic review and meta-analysis of prospective trials and observational studies were conducted.
  • Data from nine studies involving over 81,000 vaccinated and 255,000 unvaccinated pregnant individuals were analyzed.
  • Random-effects models were used to calculate odds ratios for primary (neonatal) and secondary (maternal) outcomes.

Main Results:

  • COVID-19 vaccination in pregnancy was linked to a reduced risk of neonatal intensive care unit (NICU) admission (OR, 0.88) and intrauterine fetal death (IFD) (OR, 0.73).
  • No significant associations were found with preterm birth, small for gestational age, or low Apgar scores.
  • Vaccination correlated with a lower risk of maternal SARS-CoV-2 infection (OR, 0.46) and did not increase risks for cesarean delivery, postpartum hemorrhage, or chorioamnionitis.

Conclusions:

  • COVID-19 vaccination during pregnancy is not associated with an increased risk of adverse peripartum outcomes.
  • The findings support a decreased risk of NICU admission, IFD, and maternal SARS-CoV-2 infection following vaccination.
  • COVID-19 vaccination should be encouraged for pregnant individuals based on these safety and benefit profiles.
Abstract

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