Association Between Antenatal COVID-19 Vaccination and Neonatal Outcomes

Area of Science:

• Obstetrics and Gynecology
• Vaccinology
• Neonatal Health

Background:

• COVID-19 vaccines are crucial for pandemic control.
• Misinformation persists regarding vaccine safety in pregnant women, especially with heterologous vaccination schedules.
• Investigating neonatal outcomes following maternal COVID-19 vaccination is essential.

Purpose of the Study:

• To assess the association between maternal COVID-19 vaccination during pregnancy and key neonatal outcomes.
• To address safety concerns surrounding COVID-19 vaccination in pregnant populations.
• To provide evidence-based information for public health recommendations.

Main Methods:

• Retrospective cohort study of 4032 pregnant women (September 2021 - December 2023).
• Data collected on demographics, vaccination status (including type and timing), and neonatal outcomes.
• Statistical analysis using descriptive statistics and logistic regression.

Main Results:

• COVID-19 vaccination during pregnancy was associated with significantly lower rates of stillbirth (aOR: 0.41) and small for gestational age (SGA) (aOR: 0.27).
• Vaccination in the second or third trimester correlated with reduced abortion, stillbirth, SGA, and low 5-minute Apgar scores.
• mRNA vaccination showed a lower rate of abortion and stillbirth compared to no vaccination.

Conclusions:

• Maternal COVID-19 vaccination during pregnancy is not linked to increased adverse neonatal outcomes.
• Vaccination is associated with a reduced incidence of stillbirth and SGA.
• Favorable associations observed with later-trimester vaccination and adequate vaccination status support the safety and efficacy of COVID-19 vaccines in pregnancy.