Is it safe and effective to administer COVID-19 vaccines during pregnancy? A systematic review and meta-analysis

Hameed, Ishaque; Khan, Mohammad Omer; Nusrat, Khushboo; Mahmood, Samar; Nashit, Muhammad; Malik, Shanza; Siddiqui, Omer Mustafa; Samad, Syed Abdus; Marsia, Shayan; Usman, Muhammad; Siddiqi, Tariq Jamal

doi:10.1016/j.ajic.2022.08.014

Cited by 16 publications

(16 citation statements)

References 29 publications

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“…Notably, in univariate analysis, only meconium aspiration syndrome rates were found significantly lower among women who received the third booster dose compared to unvaccinated women. In a recent systematic review and meta-analysis who evaluated the neonate’s outcome, two doses of the vaccine were observed to be protective against NICU admissions [ 27 ]. In the study of Dick et al who examined some neonate’s outcomes of women who received the third booster dose, the rates of Umbilical artery pH<7.1 was significantly lower among the third doses group compared to unvaccinated women [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Covid-19 third vaccination during pregnancy: maternal and neonatal outcomes—a retrospective study

Rottenstreich

Rotem

Wiener-Well

et al. 2022

Arch Gynecol Obstet

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Purpose To evaluate the impact of Covid-19 (Pfizer-BioNTech BNT162b2) third booster dose vaccination during pregnancy on maternal and neonatal outcomes. Methods This is a multicenter, retrospective computerized database study. Parturients who delivered in Israel between August and December 2021 with full records of Covid-19 disease and vaccination status were included. Those who received third booster during pregnancy were compared to those who received two doses of vaccine during pregnancy and to unvaccinated parturients. Various adverse maternal and neonatal outcomes were evaluated. Parturients who were previously positive with Covid-19 PCR swabs during pregnancy or before pregnancy were excluded. Univariate analysis was followed by multivariate analysis. Results A total of 2583 women were included in the analysis; 626 received the third booster dose of the BNT162b2 Covid-19 vaccine, 1094 received two doses of the vaccine, and 863 unvaccinated women. Maternal and neonatal outcomes were comparable between the study groups. An adjusted multivariable logistic regression analysis demonstrated that receiving the third booster was not associated with an increase in neither composite adverse maternal or neonatal outcome (aOR 0.9; 95% CI [0.65–1.22], p = 0.47; aOR 0.7; 95% CI [0.53–1.035], p = 0.09, respectively) when compared to those who received two doses of the vaccine. However, administration of the third booster dose during pregnancy was associated with a reduced composite adverse neonatal outcome when compared to unvaccinated women (aOR 0.6; 95% CI [0.42–0.86], p = 0.01). Conclusion Receiving the third booster dose of the BNT162b2 Covid-19 vaccine during pregnancy is not associated with an increased risk of any adverse maternal outcomes and may be beneficial for the neonates.

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Section: Discussionmentioning

confidence: 99%

Covid-19 third vaccination during pregnancy: maternal and neonatal outcomes—a retrospective study

Rottenstreich

Rotem

Wiener-Well

et al. 2022

Arch Gynecol Obstet

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“…A systematic review of 10 observational studies found that COVID-19 vaccination during pregnancy was associated with a reduced number of SARS-CoV-2 infections [odds ratio (OR) 0.56 (95% CI 0.47–0.67)] and COVID-19 related hospitalisations [OR 0.50, 95% CI (0.31–0.82)] [ 17 ]. On the other hand, COVID-19 vaccination was not associated with adverse outcomes in pregnancy, such as preeclampsia, eclampsia, stroke, postpartum haemorrhage, miscarriage prior to 20 weeks’ gestation or ectopic pregnancy [ 17 , 18 ▪ ]. Furthermore, the COVID-19 vaccine was associated with a decrease in neonatal COVID-19 intensive care unit (ICU) admission [OR 0.85 (95% CI 0.81–0.90)].…”

Section: Coronavirus Disease 2019 Vaccine Effectivenessmentioning

confidence: 99%

Effectiveness and safety of coronavirus disease 2019 vaccines

Shi

Robertson

Sheikh

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewTo review and summarise recent evidence on the effectiveness of coronavirus disease 2019 (COVID-19) vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 hospitalisation and death in adults as well as in specific population groups, namely pregnant women, and children and adolescents. We also sought to summarise evidence on vaccine safety in relation to cardiovascular and neurological complications. In order to do so, we drew primarily on evidence from two our own data platforms and supplement these with insights from related large population-based studies and systematic reviews.Recent findingsAll studies showed high vaccine effectiveness against confirmed SARS-CoV-2 infection and in particular against COVID-19 hospitalisation and death. However, vaccine effectiveness against symptomatic COVID-19 infection waned over time. These studies also found that booster vaccines would be needed to maintain high vaccine effectiveness against severe COVID-19 outcomes. Rare cardiovascular and neurological complications have been reported in association with COVID-19 vaccines.SummaryThe findings from this paper support current recommendations that vaccination remains the safest way for adults, pregnant women, children and adolescents to be protected against COVID-19. There is a need to continue to monitor the effectiveness and safety of COVID-19 vaccines as these continue to be deployed in the evolving pandemic.

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“…Emerging evidence from large‐scale cohort studies suggests that vaccination during pregnancy is not associated with any adverse maternal and neonatal outcomes 17,19,21–26 . Recently, several systematic reviews and meta‐analyses on the effectiveness of COVID‐19 vaccination during pregnancy have been published 27–30 . However, all these included a small number of studies and did not consider the quality of included studies according to matched or adjusted data based on gestational age (GA) and other confounding factors, resulting in inconsistency in findings relating to maternal and neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…However, all these included a small number of studies and did not consider the quality of included studies according to matched or adjusted data based on gestational age (GA) and other confounding factors, resulting in inconsistency in findings relating to maternal and neonatal outcomes. The effectiveness of COVID‐19 vaccination during pregnancy varied from 46% 28 to 89% 30 in these reviews. Moreover, three systematic reviews reported no association between COVID‐19 vaccination during pregnancy and neonatal ICU admission, 27,29,30 while another review reported a significant decreased risk by 15% 28 .…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of COVID‐19 vaccination during pregnancy varied from 46% 28 to 89% 30 in these reviews. Moreover, three systematic reviews reported no association between COVID‐19 vaccination during pregnancy and neonatal ICU admission, 27,29,30 while another review reported a significant decreased risk by 15% 28 . Additionally, there was no evidence of a higher risk of stillbirth in vaccinated pregnant women in three reviews, 27–29 while in another review, there was a significantly lower risk in the vaccinated cohort by 15% 30 .…”

Section: Introductionmentioning

confidence: 99%

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Effects of COVID‐19 vaccination during pregnancy on SARS‐CoV‐2 infection and maternal and neonatal outcomes: A systematic review and meta‐analysis

Rahmati

Yon

Lee

et al. 2023

Reviews in Medical Virology

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SARS‐CoV‐2 infection during pregnancy is associated with adverse maternal and neonatal outcomes, but no systematic synthesis of evidence on COVID‐19 vaccination during pregnancy against these outcomes has been undertaken. Thus, we aimed to assess the collective evidence on the effects of COVID‐19 vaccination during pregnancy on maternal and neonatal outcomes. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched for articles published up to 1 November 2022. A systematic review and meta‐analysis were performed to calculate pooled effects size and 95% confidence interval (CI). We evaluated 30 studies involving 862,272 individuals (308,428 vaccinated and 553,844 unvaccinated). Overall pooled analyses in pregnant women during pregnancy showed reduced risks of SARS‐CoV‐2 infection by 60% (41%–73%), COVID‐19 hospitalisation during pregnancy by 53% (31%–69%), and COVID‐19 intensive care unit (ICU) admission by 82% (12%–99%). Neonates of vaccinated women were 1.78 folds more likely to acquire SARS‐CoV‐2 infection during the first 2, 4 and 6 months of life during the Omicron period. The risk of stillbirth was reduced by 45% (17%–63%) in association with vaccination (vs. no vaccination) in pregnancy. A decrease of 15% (3%–25%), 33% (14%–48%), and 33% (17%–46%) in the odds of preterm births before 37, 32 and 28 weeks' gestation were associated with vaccination (vs. no vaccination) in pregnancy, respectively. The risk of neonatal ICU admission was significantly lower by 20% following COVID‐19 vaccination in pregnancy (16%–24%). There was no evidence of a higher risk of adverse outcomes including miscarriage, gestational diabetes, gestational hypertension, cardiac problems, oligohydramnios, polyhydramnios, unassisted vaginal delivery, cesarean delivery, postpartum haemorrhage, gestational age at delivery, placental abruption, Apgar score at 5 min below 7, low birthweight (<2500 g), very low birthweight (<1500 g), small for gestational age, and neonatal foetal abnormalities. COVID‐19 vaccination during pregnancy is safe and highly effective in preventing maternal SARS‐CoV‐2 infection in pregnancy, without increasing the risk of adverse maternal and neonatal outcomes, and is associated with a reduction in stillbirth, preterm births, and neonatal ICU admission. Importantly, maternal vaccination did not reduce the risk of neonatal SARS‐CoV‐2 infection during the first 6 months of life during the Omicron period.

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Is it safe and effective to administer COVID-19 vaccines during pregnancy? A systematic review and meta-analysis

Cited by 16 publications

References 29 publications

Covid-19 third vaccination during pregnancy: maternal and neonatal outcomes—a retrospective study

Covid-19 third vaccination during pregnancy: maternal and neonatal outcomes—a retrospective study

Effectiveness and safety of coronavirus disease 2019 vaccines

Effects of COVID‐19 vaccination during pregnancy on SARS‐CoV‐2 infection and maternal and neonatal outcomes: A systematic review and meta‐analysis

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