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Published in: BMC Pregnancy and Childbirth 1/2022

Open Access 01-12-2022 | Vaccination | Research

Safety of SARS-CoV-2 vaccination during pregnancy- obstetric outcomes from a large cohort study

Authors: Aharon Dick, Joshua I Rosenbloom, Einat Gutman-Ido, Naama Lessans, Adva Cahen-Peretz, Henry H Chill

Published in: BMC Pregnancy and Childbirth | Issue 1/2022

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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.
Literature
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Metadata
Title
Safety of SARS-CoV-2 vaccination during pregnancy- obstetric outcomes from a large cohort study
Authors
Aharon Dick
Joshua I Rosenbloom
Einat Gutman-Ido
Naama Lessans
Adva Cahen-Peretz
Henry H Chill
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2022
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-022-04505-5

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