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Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Author

Listed:
  • Smriti Prasad

    (St George’s University of London)

  • Erkan Kalafat

    (Middle East Technical University
    Koc University)

  • Helena Blakeway

    (St George’s University of London)

  • Rosemary Townsend

    (University of Edinburgh
    St George’s University of London)

  • Pat O’Brien

    (The Royal College of Obstetricians and Gynaecologists
    University College London Hospitals NHS Foundation Trust)

  • Edward Morris

    (The Royal College of Obstetricians and Gynaecologists
    Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich)

  • Tim Draycott

    (The Royal College of Obstetricians and Gynaecologists
    North Bristol NHS Trust Department of Women’s Health, Westbury-on-Trym)

  • Shakila Thangaratinam

    (University of Birmingham)

  • Kirsty Le Doare

    (St George’s University of London)

  • Shamez Ladhani

    (Public Health England
    Royal College of Paediatrics and Child Health)

  • Peter von Dadelszen

    (King’s College London)

  • Laura A. Magee

    (King’s College London)

  • Paul Heath

    (St George’s University of London)

  • Asma Khalil

    (St George’s University of London
    St George’s University of London)

Abstract

Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73–0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

Suggested Citation

  • Smriti Prasad & Erkan Kalafat & Helena Blakeway & Rosemary Townsend & Pat O’Brien & Edward Morris & Tim Draycott & Shakila Thangaratinam & Kirsty Le Doare & Shamez Ladhani & Peter von Dadelszen & Laur, 2022. "Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-30052-w
    DOI: 10.1038/s41467-022-30052-w
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    References listed on IDEAS

    as
    1. João Viana & Christiaan H. Dorp & Ana Nunes & Manuel C. Gomes & Michiel Boven & Mirjam E. Kretzschmar & Marc Veldhoen & Ganna Rozhnova, 2021. "Controlling the pandemic during the SARS-CoV-2 vaccination rollout," Nature Communications, Nature, vol. 12(1), pages 1-15, December.
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    Cited by:

    1. Laura Lindsay & Clara Calvert & Ting Shi & Jade Carruthers & Cheryl Denny & Jack Donaghy & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Terry McLaughlin & Emily Moore & Bob Taylor & Krishnan, 2023. "Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
    2. Clara Calvert & Jade Carruthers & Cheryl Denny & Jack Donaghy & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Laura Lindsay & Terry McLaughlin & Emily Moore & Bob Taylor & Maria Loane & Helen, 2023. "A population-based matched cohort study of major congenital anomalies following COVID-19 vaccination and SARS-CoV-2 infection," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    3. Joshua Guedalia & Michal Lipschuetz & Ronit Calderon-Margalit & Sarah M. Cohen & Debra Goldman-Wohl & Tali Kaminer & Eli Melul & Galit Shefer & Yishai Sompolinsky & Asnat Walfisch & Simcha Yagel & Ofe, 2022. "Effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy: a national observational study in Israel," Nature Communications, Nature, vol. 13(1), pages 1-7, December.
    4. Laura A. Magee & Erika Molteni & Vicky Bowyer & Jeffrey N. Bone & Harriet Boulding & Asma Khalil & Hiten D. Mistry & Lucilla Poston & Sergio A. Silverio & Ingrid Wolfe & Emma L. Duncan & Peter von Dad, 2023. "National surveillance data analysis of COVID-19 vaccine uptake in England by women of reproductive age," Nature Communications, Nature, vol. 14(1), pages 1-8, December.
    5. Clara Calvert & Jade Carruthers & Cheryl Denny & Jack Donaghy & Sam Hillman & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Laura Lindsay & Terry McLaughlin & Emily Moore & Jiafeng Pan & Bob , 2022. "A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection," Nature Communications, Nature, vol. 13(1), pages 1-10, December.
    6. Olivia M. Man & Tamiris Azamor & Mary Catherine Cambou & Trevon L. Fuller & Tara Kerin & Sophia G. Paiola & Jessica S. Cranston & Thalia Mok & Rashmi Rao & Weiqiang Chen & Jae U. Jung & Viviana Fajard, 2024. "Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study," Nature Communications, Nature, vol. 15(1), pages 1-11, December.

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