Association of BNT162b2 COVID-19 Vaccination During Pregnancy With Neonatal and Early Infant Outcomes

Goldshtein, Inbal; Steinberg, David M.; Kuint, Jacob; Chodick, Gabriel; Segal, Yaakov; David, Shirley Shapiro Ben; Ben‐Tov, Amir

doi:10.1001/jamapediatrics.2022.0001

Cited by 120 publications

(204 citation statements)

References 18 publications

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“…Sample size ranged from 473 (Siegel et al, 2021) to 355,299 pregnant women (UK Health Security Agency, 2021). Eight studies were cohort studies (Blakeway et al, 2022; Goldshtein et al, 2022; Lipkind et al, 2022; Razzaghi et al, 2021; Rottenstreich et al, 2022; Stock et al, 2022; UK Health Security Agency, 2021; Wainstock et al, 2021) and three studies were cross-sectional (Hosokawa et al, 2022; Siegel et al, 2021; Taubman – Ben=Ari et al, 2022). Two studies used national data (Stock et al, 2022; UK Health Security Agency, 2021), three studies used a convenience sample (Hosokawa et al, 2022; Siegel et al, 2021; Taubman – Ben=Ari et al, 2022), and six studies did not report the sampling method (Blakeway et al, 2022; Goldshtein et al, 2022; Lipkind et al, 2022; Razzaghi et al, 2021; Rottenstreich et al, 2022; Wainstock et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were cohort studies (Blakeway et al, 2022; Goldshtein et al, 2022; Lipkind et al, 2022; Razzaghi et al, 2021; Rottenstreich et al, 2022; Stock et al, 2022; UK Health Security Agency, 2021; Wainstock et al, 2021) and three studies were cross-sectional (Hosokawa et al, 2022; Siegel et al, 2021; Taubman – Ben=Ari et al, 2022). Two studies used national data (Stock et al, 2022; UK Health Security Agency, 2021), three studies used a convenience sample (Hosokawa et al, 2022; Siegel et al, 2021; Taubman – Ben=Ari et al, 2022), and six studies did not report the sampling method (Blakeway et al, 2022; Goldshtein et al, 2022; Lipkind et al, 2022; Razzaghi et al, 2021; Rottenstreich et al, 2022; Wainstock et al, 2021). Ten studies were published in peer-reviewed journals (Blakeway et al, 2022; Goldshtein et al, 2022; Hosokawa et al, 2022; Lipkind et al, 2022; Razzaghi et al, 2021; Rottenstreich et al, 2022; Stock et al, 2022; Taubman – Ben=Ari et al, 2022; UK Health Security Agency, 2021; Wainstock et al, 2021) and one study in a pre-print service (Siegel et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…The heterogeneity between results was very high (I 2 =99.98%, p-value for the Hedges Q statistic<0.001). A leave-one-out sensitivity analysis showed that no single study had a disproportional effect on the overall proportion, which varied between 23.5% (95% CI: 18.5-28.8%), with Goldshtein et al (2022) excluded, and 29.7% (95% CI: 18.9-41.9%), with UK Health Security Agency (2021) excluded. Publication bias was probable according to Egger’s test (<0.05) and funnel plot (Supplementary Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…The overall proportion of vaccinated pregnant women against the COVID-19 was 27.5% (95% CI: 18.8-37.0%) (Figure 2). COVID-19 vaccination uptake among pregnant women ranged from 7.0% (95% CI: 6.9-7.1%) (UK Health Security Agency, 2021) to 68.7% (95% CI: 68.2-69.3%) (Goldshtein et al, 2022). The heterogeneity between results was very high (I 2 =99.98%, p-value for the Hedges Q statistic<0.001).…”

Section: Covid-19 Vaccination Uptakementioning

confidence: 99%

See 3 more Smart Citations

Uptake of COVID-19 vaccines among pregnant women: a systematic review and meta-analysis

Galanis

Vraka

Σίσκου

et al. 2022

Preprint

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Background: Mass vaccination against the COVID-19 is essential to control the pandemic. COVID-19 vaccines are recommended now during pregnancy to prevent adverse outcomes. Objective: To evaluate the evidence from the literature regarding the uptake of COVID-19 vaccination among pregnant women. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We searched PubMed, Medline, Scopus, ProQuest, Web of Science, CINAHL, and a pre-print service (medRxiv) from inception to March 23, 2022. We included quantitative studies reporting COVID-19 vaccination uptake among pregnant women, studies that examine predictors of COVID-19 vaccination uptake and studies that examine reasons for decline of vaccination. We performed meta-analysis to estimate the overall proportion of vaccinated pregnant women against the COVID-19. Results: We found 11 studies including 703,004 pregnant women. The overall proportion of vaccinated pregnant women against the COVID-19 was 27.5% (95% CI: 18.8-37.0%). The pooled proportion for studies that were conducted in Israel was higher than the proportion for studies that were conducted in USA and other countries. Predictors of COVID-19 vaccination uptake were older age, ethnicity, race, trust in COVID-19 vaccines, and fear of COVID-19 during pregnancy. On the other hand, mistrust in the government, diagnosis with COVID-19 during pregnancy, and worry about the safety and the side effects of the COVID-19 vaccines were reasons for decline of vaccination. Conclusions: The global COVID-19 vaccination prevalence in pregnant women is low. Τhere is a large gap in the literature on the factors influencing the decision of pregnant women to be vaccinated against the COVID-19. Targeted information campaigns are essential to improve trust and build vaccine literacy among pregnant women. Given the ongoing high case rates and the known increased risks of COVID-19 in pregnant women, our findings could help policy makers to improve the acceptance rate of COVID-19 vaccines in pregnant women especially in vulnerable subgroups.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Covid-19 Vaccination Uptakementioning

confidence: 99%

See 2 more Smart Citations

Uptake of COVID-19 vaccines among pregnant women: a systematic review and meta-analysis

Galanis

Vraka

Σίσκου

et al. 2022

Preprint

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“…This study contributes to current evidence in establishing the safety of prenatal vaccine exposure to newborns. However, the interpretation of study findings is limited by the observational design ( Goldshtein et al, 2022 ).…”

Section: The Impact Of Coronavirus Disease 2019 Vaccine On Pregnancymentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy. A Non-systematic Review of Clinical Presentation, Potential Effects of Physiological Adaptations in Pregnancy, and Placental Vascular Alterations

et al. 2022

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In December 2019, the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) rapidly spread to become a pandemic. To date, increasing evidence has described the potential negative impact of SARS-CoV-2 infection on pregnant women. Although the pathophysiology of coronavirus disease 2019 (COVID-19) is not entirely understood, there is emerging evidence that it causes a severe systemic inflammatory response associated with vascular alterations that could be of special interest considering some physiological changes in pregnancy. Additionally, these alterations may affect the physiology of the placenta and are associated with pregnancy complications and abnormal histologic findings. On the other hand, data about the vaccine against SARS-CoV-2 are limited, but the risks of administering COVID-19 vaccines during pregnancy appear to be minimal. This review summarizes the current literature on SARSCoV2 virus infection, the development of COVID-19 and its relationship with physiological changes, and angiotensin-converting enzyme 2 (ACE2) function during pregnancy. We have particularly emphasized evidence coming from Latin American countries.

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COVID-19 mRNA Vaccines During Pregnancy

Kharbanda

Vazquez‐Benitez

2022

JAMA

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SARS-CoV-2 infection during pregnancy is associated with increased risk for maternal morbidity and adverse birth outcomes. 1,2 COVID-19 vaccines are effective for preventing severe disease, including in pregnant populations. 3 Although more than 100 countries recommend COVID-19 vaccination during pregnancy, 4 COVID-19 vaccination in pregnant people has lagged behind that for age-matched, nonpregnant adults. 5,6 As of February 2022, the US Vaccine Safety Datalink estimated that 68% of pregnant individuals have completed the primary COVID-19 vaccine series. 6 Persistent wide disparities in COVID-19 vaccination during pregnancy by race or ethnicity are likely to exacerbate longstanding disparities in maternal morbidity and mortality. 6 Vaccine hesitancy during pregnancy was understandable when COVID-19 vaccines were first authorized, 7 because pregnant people were excluded from the initial COVID-19 vaccine trials. Thus, initial data on pregnancy or birth outcomes after maternal COVID-19 vaccination were limited to inadvertent exposures among trial participants early in pregnancy. The mRNA vaccines were novel and their safety in pregnancy was presumed, but not yet proven. Over the past 14 months, a substantial body of evidence supporting the safety of the mRNA COVID-19 vaccines in pregnancy has accumulated. Observational studies from Norway, Israel, and the US have reported that the mRNA COVID-19 vaccines administered during pregnancy were not associated with increased risk for miscarriage, preterm birth, or other select obstetric and birth outcomes. [8][9][10][11] In this issue of JAMA, 2 population-based observational retrospective studies evaluating outcomes in more than 250 000 pregnancies from 3 countries together provide the strongest evidence to date regarding the safety of COVID-19 vaccines in pregnancy. 12,13 Fell and colleagues 12 used data from the Ontario birth registry, linked with the provincial immunization information system, to identify 97 590 pregnancies eligible for COVID-19 vaccination and with an expected delivery date or live birth from December 14, 2020, to September 30, 2021. Of these pregnant individuals, 23% were vaccinated during pregnancy; most were vaccinated in third trimester. Compared with those vaccinated after pregnancy and, in separate analyses, compared with those who were unvaccinated during pregnancy, COVID-19 vaccination during pregnancy was not associated with increased risks for postpartum hemorrhage, chorioamnionitis, cesarean delivery, neonatal care admission, or low Apgar score.

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Association of BNT162b2 COVID-19 Vaccination During Pregnancy With Neonatal and Early Infant Outcomes

Cited by 120 publications

References 18 publications

Uptake of COVID-19 vaccines among pregnant women: a systematic review and meta-analysis

Uptake of COVID-19 vaccines among pregnant women: a systematic review and meta-analysis

Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy. A Non-systematic Review of Clinical Presentation, Potential Effects of Physiological Adaptations in Pregnancy, and Placental Vascular Alterations

COVID-19 mRNA Vaccines During Pregnancy

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