The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis

Wei, Shu Qin; Bilodeau-Bertrand, Marianne; Liu, Shiliang; Auger, Nathalie

doi:10.1503/cmaj.202604

Cited by 646 publications

(685 citation statements)

References 58 publications

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“…COVID-19 vaccines are critical for ending the COVID-19 pandemic; however, current data about vaccination coverage and safety in pregnant women are limited. Pregnant women are at increased risk for severe illness and death from COVID-19 compared with nonpregnant women of reproductive age, and are at risk for adverse pregnancy outcomes, such as preterm birth (1)(2)(3)(4). Pregnant women are eligible for and can receive any of the three COVID-19 vaccines available in the United States via Emergency Use Authorization.…”

mentioning

confidence: 99%

COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021

Razzaghi¹,

Meghani²,

Pingali³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

165

167

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mentioning

confidence: 99%

COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021

Razzaghi¹,

Meghani²,

Pingali³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

165

167

View full text Add to dashboard Cite

“…4 Whilst the majority of COVID-19 infections in pregnancy are asymptomatic 5 and the absolute risk for extreme negative outcomes such as ICU admission, mechanical ventilation and death is low, observational data suggests that pregnant women are at risk of severe illness, particularly in their third trimester. 5,6,7 Despite this, pregnant women were not part of initial COVID-19 vaccine trials. Fortunately, initiatives to involve pregnant women in COVID-19 vaccine trials are underway.…”

Section: Effect Of Covid-19 On Pregnancymentioning

confidence: 99%

“…8 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy has been linked to an increased incidence of preeclampsia, preterm birth (mostly iatrogenic for maternal and fetal compromise), 4,5 stillbirth, thromboembolic disease and caesarean delivery. 6,9 Vertical transmission remains a topic of debate with current available data suggesting an approximate 2% -3% risk of transmission. 9 However, the World Health Organization cautions that, as a result of a lack of standardised definitions and adequate diagnostic tests, further study needs to occur.…”

Section: Effect Of Covid-19 On Pregnancymentioning

confidence: 99%

Perspectives on COVID-19 vaccination for pregnant women in South Africa

Hunter

Moodley

Moran

2021

African Journal of Primary Health Care & Family Medicine

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Coronavirus disease 2019 (COVID-19) is a pandemic that has created a global health crisis and upended conventional methodologies, both in the governance and clinical structures of Health Care Systems. The spread of COVID-19 has necessitated a coordinated public health response in an effective, extensive and expedited vaccination rollout strategy with the ultimate aim of limiting all nidi of infection for the pathogen. For this goal to be realised, pregnant women, as a cohort, cannot reasonably be excluded from this initiative, despite the initial reluctance to include them in clinical trials for various ethical and legal reasons. Weighing the detrimental complications of COVID-19 on maternal and perinatal outcomes against the hypothetical risk of vaccination in the context of promising, albeit indirect, safety and efficacy data, this report argues that all pregnant women should be offered the choice of whether or not to receive the COVID-19 vaccine based on the available evidence and their individualised risk-benefit ratio.

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“…COVID-19 vaccines are currently the leading approach for combating the pandemic's advance. Phase III clinical trials conducted to evaluate the safety and e cacy of mRNA COVID-19 vaccines did not include pregnant women, even though they are at risk for severe COVID-19 (1) and potentially for adverse pregnancy outcomes (2). Ongoing trials are limited to late pregnancy vaccination and surrogate e cacy outcomes (i.e., immunogenicity).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the BNT162b2 mRNA COVID-19 Vaccine in Pregnancy

Balicer

Dagan

Barda

et al. 2021

Preprint

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Background: As mass vaccination campaigns against COVID-19 accelerate worldwide, there remains only limited evidence regarding vaccine effectiveness (VE) among pregnant women. Pregnant women have been shown to be at risk for severe COVID-19, resulting in adverse obstetrics outcomes, and their immune system is known to undergo alterations during pregnancy. Phase III clinical trials of the approved mRNA COVID-19 vaccines excluded pregnant women, yet current guidelines encourage offering the vaccine to pregnant women. In this study, we examine data from Israel’s largest healthcare organization to evaluate the effectiveness of the BNT162b2 mRNA vaccine among pregnant women. Methods: We conducted an observational cohort study of pregnant women 16 years or older, with no history of SARS-CoV-2, who were vaccinated between December 20, 2020 and June 3, 2021. Vaccinated subjects were matched to unvaccinated controls according to a set of demographic and clinical characteristics. Study outcomes included documented infection with SARS-CoV-2, symptomatic COVID-19, COVID-19-related hospitalization, severe illness and death. For each outcome, VE was estimated at several periods following vaccination as one minus the risk ratio using the Kaplan–Meier estimator. Results: 10,861 vaccinated women were matched to an identical number of unvaccinated controls. Estimated VE from 7 through 28 days after the second dose was 97% (95% CI 91%-100%) for any documented infection, 96% (86-100%) for infections with documented symptoms, and 85% (32%-100%) for COVID-19-related hospitalization. Only one event of severe illness was observed in the unvaccinated group, and no deaths were observed in either group -- insufficient incidence for estimating VE for these outcomes. Discussion: The BNT162b2 mRNA vaccine was found to have high VE among pregnant women. Since high VE has been reported as one of the strongest predictors of COVID-19 vaccine acceptance among pregnant women, the high VE estimates found in this study have the potential to increase vaccine acceptance in this group. In addition, the present VE estimates are similar to those reported in the general population for the same variants, suggesting that it may be possible to infer the VE for pregnant women from studies in the general population for both current and future variants.

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The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis

Cited by 646 publications

References 58 publications

COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021

COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021

Perspectives on COVID-19 vaccination for pregnant women in South Africa

Effectiveness of the BNT162b2 mRNA COVID-19 Vaccine in Pregnancy

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