Impact of prenatal COVID-19 vaccination on delivery and neonatal outcomes: Results from a New York City cohort

Ibroci, Erona; Liu, Xiaoqin; Lieb, Whitney; Jessel, Rebecca H.; Gigase, Frederieke; Chung, Kyle; Graziani, Mara; Lieber, Molly; Ohrn, Sophie; Lynch, Jezelle; Castro, Juliana; Marshall, Christina L.; Tubassum, Rushna; Mutawakil, Farida; Kaplowitz, Elianna; Ellington, Sascha; Molenaar, Nina M.; Sperling, Rhoda; Howell, Elizabeth A.; Janević, Teresa; Dolan, Siobhan M.; Stone, Joanne; Witte, Lotje D. De; Rommel, Anna‐Sophie

doi:10.1016/j.vaccine.2022.09.095

Cited by 10 publications

(22 citation statements)

References 41 publications

(83 reference statements)

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“…Our results are consistent with previously published studies that reported no increased risk of NICU admission among infants of mothers who received 1 or more mRNA COVID-19 vaccine dose(s) during pregnancy compared with infants of unvaccinated mothers . Most of these studies did not include sufficient numbers of infants to produce precise estimates .…”

Section: Discussionsupporting

confidence: 90%

“…First, it provides further reassurance on the safety of maternal mRNA COVID-19 vaccination during all trimesters of pregnancy for newborns and infants. Second, it adds to existing evidence [15][16][17][18][19][20][21][22] suggesting that not only are there no apparent increased risks of the adverse neonatal and early infant outcomes evaluated in this study following maternal COVID-19 vaccination during pregnancy, but there may be potential benefits. While it is possible that residual confounding might have biased estimates away from the null, as suggested by our quantitative bias analyses, except for the most extreme scenarios, biascorrected estimates for SNM, neonatal death, and NICU admission remained less than 1 after accounting for hypothetical unmeasured confounding.…”

Section: Discussionmentioning

confidence: 72%

“…16,[19][20][21] Moreover, less than 25% of mothers were vaccinated in many studies, [16][17][18][19][20] compared with 60% in the present study and first trimester exposures were either absent 19,21 or underrepresented. [16][17][18]20 Our results are also comparable with a study from 2 university-affiliated hospitals in Israel (n = 1750) that assessed the association between third trimester maternal BNT162b2 vaccination and a composite neonatal adverse outcome indicator, which had overlap with the SNM indicator we used. 21 Similar to our finding, neonatal adverse outcomes were lower among infants of vaccinated mothers (8% vs 11%; adjusted odds ratio, 0.50; 95% CI, 0.36-0.74).…”

Section: Comparison With Other Studiesmentioning

confidence: 83%

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Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy

Jorgensen,

Drover,

Fell

et al. 2023

JAMA Pediatr

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ImportanceThe study team previously showed that maternal mRNA COVID-19 vaccination during pregnancy confers protection against SARS-CoV-2 infection and COVID-19–related hospital admission in newborns and young infants. In this study, the study team evaluated newborn and early infant safety outcomes following maternal messenger RNA (mRNA) COVID-19 vaccination during pregnancy, for which there is limited comparative epidemiological evidence.ObjectiveTo determine if maternal mRNA COVID-19 vaccination during pregnancy is associated with adverse newborn and early infant outcomes.Design, Setting, and ParticipantsThis population-based retrospective cohort study took place in Ontario, Canada, using multiple linked health administrative databases. Singleton live births with an expected delivery date between May 1, 2021, and September 2, 2022, were included. Data were analyzed from January 2023 through March 2023.ExposureMaternal mRNA COVID-19 vaccination (1 or more doses) during pregnancyMain Outcomes and MeasuresSevere neonatal morbidity (SNM), neonatal death, neonatal intensive care unit (NICU) admission, neonatal readmission, and hospital admission up to 6 months of age. The study team calculated inverse probability of treatment weighted risk ratios (RRs) and fit weighted Cox proportional hazards regression models comparing outcomes in infants of mothers who received COVID-19 vaccination during pregnancy with those who received no COVID-19 vaccine doses before delivery.ResultsIn total, 142 006 infants (72 595 male [51%]; mean [SD] gestational age at birth, 38.7 [1.7] weeks) were included; 85 670 were exposed to 1 or more COVID-19 vaccine doses in utero (60%). Infants of vaccinated mothers had lower risks of SNM (vaccine exposed 7.3% vs vaccine unexposed 8.3%; adjusted RR [aRR], 0.86; 95% CI, 0.83-0.90), neonatal death (0.09% vs 0.16%; aRR, 0.47; 95% CI, 0.33-0.65), and NICU admission (11.4% vs 13.1%; aRR, 0.86; 95% CI, 0.83-0.89). There was no association between maternal vaccination during pregnancy and neonatal readmission (5.5% vs 5.1%; adjusted hazard ratio, 1.03; 95% CI, 0.98-1.09) or 6-month hospital admission (8.4% vs 8.1%; adjusted hazard ratio, 1.01; 95% CI, 0.96-1.05).Conclusions and RelevanceIn this population-based cohort study in Ontario, Canada, maternal mRNA COVID-19 vaccination during pregnancy was associated with lower risks of SNM, neonatal death, and NICU admission. In addition, neonatal and 6-month readmissions were not increased in infants of mothers vaccinated during pregnancy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 72%

Section: Comparison With Other Studiesmentioning

confidence: 83%

See 1 more Smart Citation

Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy

Jorgensen,

Drover,

Fell

et al. 2023

JAMA Pediatr

View full text Add to dashboard Cite

show abstract

“…Surveys of pregnant people reported decreased intention to become vaccinated, largely due to concerns about potential harm to the fetus [36] ; this also continues to be the most commonly-cited reason for low uptake of influenza vaccine during pregnancy [33] . Although substantial evidence on safety of COVID-19 vaccination during pregnancy has accumulated [9] , [10] , [11] , [12] , [13] , [14] , [15] , our results suggest that there is a subgroup of individuals who are less likely to get vaccinated during pregnancy. Previous studies in the general population have shown that lower socioeconomic status (e.g., lower level of education, poverty, lower household income) are risk factors for COVID-19 infection, confirmed diagnosis, and death, and that socioeconomic determinants play an important role in COVID-19 outcomes [37] , [38] , [39] , [40] .…”

Section: Discussioncontrasting

confidence: 62%

“…Vaccination during pregnancy has been found to provide similarly effective protection against COVID-19 as in non-pregnant people [4] , [5] , and reduce the risk of COVID-19 infection and hospitalization in young infants [6] , [7] , [8] . Despite these benefits, and increasing evidence that COVID-19 vaccination during pregnancy is not associated with increased risk of adverse outcomes such as spontaneous abortion, preterm birth, stillbirth, postpartum hemorrhage, low neonatal Apgar scores, or neonatal intensive care unit admission [9] , [10] , [11] , [12] , [13] , [14] , [15] , vaccine coverage has been lower in pregnant individuals in some (e.g., United States [U.S.] [16] and Scotland [17] ), but not all (e.g., Sweden and Norway [18] ), countries compared to the female population of reproductive age.…”

Section: Introductionmentioning

confidence: 99%