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

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 va...

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Bibliographic Details
Published in:Reviews in medical virology 2023-05, Vol.33 (3), p.e2434-n/a
Main Authors: Rahmati, Masoud, Yon, Dong Keon, Lee, Seung Won, Butler, Laurie, Koyanagi, Ai, Jacob, Louis, Shin, Jae Il, Smith, Lee
Format: Article
Language:English
Subjects:
Apgar score
Birth weight
Cesarean section
coronavirus disease 2019
COVID-19
COVID-19 - epidemiology
COVID-19 - prevention & control
COVID-19 Vaccines
Diabetes mellitus
Female
Gestational age
Hemorrhage
Humans
Immunization
Infant, Newborn
Infections
Life Sciences
Meta-analysis
Neonates
Placenta
Pregnancy
Pregnancy complications
Pregnancy Complications, Infectious - epidemiology
Pregnancy Complications, Infectious - prevention & control
Pregnancy Outcome
Premature birth
Premature Birth - epidemiology
preterm birth
safety
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Small for gestational age
Stillbirth
Stillbirth - epidemiology
Systematic review
Vaccination
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Summary: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 (
ISSN:1052-9276
1099-1654
DOI:10.1002/rmv.2434