TY - JOUR
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
N1 - Publisher Copyright:
© 2022, The Author(s).
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 -