Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Smriti Prasad; Erkan Kalafat; Helena Blakeway; Rosemary Townsend; Pat O'Brien; Edward Morris; Tim Draycott; Shakila Thangaratinam; Kirsty Le Doare; Shamez Ladhani; Peter von Dadelszen; Laura A Magee; Paul Heath; Asma Khalil

doi:10.1038/s41467-022-30052-w

Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Smriti Prasad, Erkan Kalafat, Helena Blakeway, Rosemary Townsend, Pat O'Brien, Edward Morris, Tim Draycott, Shakila Thangaratinam, Kirsty Le Doare, Shamez Ladhani, Peter von Dadelszen, Laura A Magee, Paul Heath, Asma Khalil

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73-0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

Original language	English
Article number	2414
Pages (from-to)	2414
Journal	Nature Communications
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41467-022-30052-w
Publication status	Published - 10 May 2022

Keywords / Materials (for Non-textual outputs)

COVID-19/prevention & control
COVID-19 Vaccines/adverse effects
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Placenta
Pregnancy
Premature Birth/epidemiology
RNA, Messenger
SARS-CoV-2
Stillbirth/epidemiology
Vaccination

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10.1038/s41467-022-30052-wLicence: Creative Commons: Attribution (CC-BY)

Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancyFinal published version, 14.9 MBLicence: Creative Commons: Attribution (CC-BY)

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Prasad, S., Kalafat, E., Blakeway, H., Townsend, R., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Le Doare, K., Ladhani, S., von Dadelszen, P., Magee, L. A., Heath, P., & Khalil, A. (2022). Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. Nature Communications, 13(1), 2414. Article 2414. https://doi.org/10.1038/s41467-022-30052-w

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title = "Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy",

abstract = "Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73-0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.",

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author = "Smriti Prasad and Erkan Kalafat and Helena Blakeway and Rosemary Townsend and Pat O'Brien and Edward Morris and Tim Draycott and Shakila Thangaratinam and {Le Doare}, Kirsty and Shamez Ladhani and {von Dadelszen}, Peter and Magee, {Laura A} and Paul Heath and Asma Khalil",

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Prasad, S, Kalafat, E, Blakeway, H, Townsend, R, O'Brien, P, Morris, E, Draycott, T, Thangaratinam, S, Le Doare, K, Ladhani, S, von Dadelszen, P, Magee, LA, Heath, P & Khalil, A 2022, 'Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy', Nature Communications, vol. 13, no. 1, 2414, pp. 2414. https://doi.org/10.1038/s41467-022-30052-w

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T1 - Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

AU - Prasad, Smriti

AU - Kalafat, Erkan

AU - Blakeway, Helena

AU - Townsend, Rosemary

AU - O'Brien, Pat

AU - Morris, Edward

AU - Draycott, Tim

AU - Thangaratinam, Shakila

AU - Le Doare, Kirsty

AU - Ladhani, Shamez

AU - von Dadelszen, Peter

AU - Magee, Laura A

AU - Heath, Paul

AU - Khalil, Asma

PY - 2022/5/10

Y1 - 2022/5/10

N2 - Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73-0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

AB - Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73-0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

KW - COVID-19/prevention & control

KW - COVID-19 Vaccines/adverse effects

KW - Female

KW - Humans

KW - Infant, Newborn

KW - Intensive Care Units, Neonatal

KW - Placenta

KW - Pregnancy

KW - Premature Birth/epidemiology

KW - RNA, Messenger

KW - SARS-CoV-2

KW - Stillbirth/epidemiology

KW - Vaccination

U2 - 10.1038/s41467-022-30052-w

DO - 10.1038/s41467-022-30052-w

M3 - Article

C2 - 35538060

SN - 2041-1723

VL - 13

SP - 2414

JO - Nature Communications

JF - Nature Communications

IS - 1

M1 - 2414

ER -

Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

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