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Safety of SARS-CoV-2 vaccination during pregnancy- obstetric outcomes from a large cohort study.
Dick, Aharon; Rosenbloom, Joshua I; Gutman-Ido, Einat; Lessans, Naama; Cahen-Peretz, Adva; Chill, Henry H.
  • Dick A; Department of Obstetrics and Gynecology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel. aharondick88@gmail.com.
  • Rosenbloom JI; Department of Obstetrics and Gynecology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel.
  • Gutman-Ido E; Department of Obstetrics and Gynecology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel.
  • Lessans N; Department of Obstetrics and Gynecology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel.
  • Cahen-Peretz A; Department of Obstetrics and Gynecology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel.
  • Chill HH; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, Skokie, IL, USA.
BMC Pregnancy Childbirth ; 22(1): 166, 2022 Feb 28.
Article in English | MEDLINE | ID: covidwho-1714652
ABSTRACT

BACKGROUND:

COVID-19 during pregnancy is associated with adverse outcomes for mother and fetus. SARS-CoV-2 vaccination has significantly reduced the risk of symptomatic disease. Several small studies have reported the safety of SARS-CoV-2 vaccination during pregnancy, with no adverse effect on obstetric outcomes.

OBJECTIVE:

To examine the association between SARS-CoV-2 vaccination during pregnancy and maternal and neonatal outcomes in a large cohort study. Furthermore, to evaluate if timing of vaccination during pregnancy is related to adverse outcomes.

METHODS:

A retrospective cohort study of women who delivered between December 2020 and July 2021 at a large tertiary medical center. Excluded were women with multiple pregnancy, vaccination prior to pregnancy, COVID-19 infection during or before pregnancy, or unknown timing of vaccination. Primary outcomes were the incidence of preterm labor and of small for gestational age. Secondary outcomes were other maternal and neonatal complications. A secondary analysis investigating the association between time of vaccination and outcomes was also performed. Multivariable logistic regression models were used to adjust for potential confounders.

RESULTS:

There were 5618 women who met the inclusion criteria 2,305 (41%) women were vaccinated and 3,313 (59%) were unvaccinated. There were no differences between vaccinated and non-vaccinated patients with respect to primary outcomes. The rate of preterm birth was 5.5% in the vaccinated group compared to 6.2% in the unvaccinated group (p = 0.31). Likewise, the rates of small for gestational age were comparable between the two groups (6.2% vs. 7.0% respectively, p = 0.2). In a secondary analysis focusing on time of vaccination and its relationship with outcomes, patients vaccinated in the second trimester (n = 964) and in the third trimester (n = 1329) were independently compared to their unvaccinated counterparts. Women who were vaccinated in the second trimester were more likely to have a preterm birth (8.1% vs. 6.2%, p < 0.001). This association persisted after adjusting for potential confounders (adjusted odds ratio 1.49, 95%CI 1.11, 2.01).

CONCLUSIONS:

SARS-CoV-2 vaccine appears to be safe during pregnancy with no increase in incidence of preterm labor and small for gestational age compared to unvaccinated women. However, in women vaccinated during the second trimester there may be an increase in the rate of preterm birth.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infant, Small for Gestational Age / Pregnancy Outcome / Vaccination / Premature Birth / Patient Safety / COVID-19 Vaccines Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adult / Female / Humans / Pregnancy Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-04505-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infant, Small for Gestational Age / Pregnancy Outcome / Vaccination / Premature Birth / Patient Safety / COVID-19 Vaccines Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adult / Female / Humans / Pregnancy Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-04505-5