Peripartum Outcomes Associated With COVID-19 Vaccination During Pregnancy

The SARS-CoV-2 infection during pregnancy associated with increased risks for the mother including morbidity, hospitalization, intensive care unit admission, and maternal death. COVID-19 infection in pregnancy and adverse events for the baby are well known and include preterm birth, stillbirth, and neonatal or perinatal morbidity.

Since the approval of COVID-19 messenger RNA (mRNA) vaccines, vaccination during pregnancy has been recommended to prevent illness in pregnant individuals and their newborns. However, vaccine hesitancy during pregnancy may still exist due to misinformation regarding vaccine safety in pregnancy.

Emerging evidence from large epidemiological studies has indicated that COVID-19 vaccination during pregnancy decreased the risk of adverse outcomes for both pregnant individuals and babies, such as miscarriage, preterm birth, and small for gestational age babies.

Population-based Observational Studies

Recently, two population-based observational studies from Canada and Sweden/Norway have provided further reassuring evidence regarding the safety of COVID-19 vaccination during pregnancy, using large cohort data on more than 250,000 pregnancies.

The objective was to evaluate the association between COVID-19 vaccination during pregnancy and peripartum outcomes. Prospective trials and observational studies compared the individual who received at least one COVID-19 vaccination during pregnancy with those who did not receive any vaccines against Covid 19.

The primary outcomes were the neonatal outcomes including preterm birth, small for gestational age, low Apgar score, NICU admission, and intrauterine fetal demise (stillbirth). The secondary outcomes were maternal outcomes, including maternal SARS-CoV-2 infection, cesarean delivery, postpartum hemorrhage, and chorioamnionitis.

Additional Studies – Vaccination During Pregnancy

Nine observational studies involving vaccinated and unvaccinated individuals during pregnancy were included. COVID-19 vaccination during pregnancy was associated with lower risk of NICU admission and IUFD. There was not a statistically significant association with vaccine administration and preterm birth, small for gestational age, and low Apgar score. COVID-19 vaccination during pregnancy was associated with a lower risk of maternal SARS-CoV-2 infection. The vaccine was not associated with increased risk of cesarean delivery, postpartum hemorrhage, and chorioamnionitis.

In conclusion, COVID-19 vaccination should be encouraged for pregnant individuals. The vaccine was not associated with any increased risks to the pregnant individual, or their babies and the benefits of the vaccine are well documented in studies.