Association of COVID-19 Vaccination During Early Pregnancy With Risk of Congenital Fetal Anomalies

Abstract

COVID-19 infection increases the risk of maternal and neonatal morbidity in the pregnant population. While data suggest that COVID-19 vaccines are safe and effective during pregnancy, the risk to the fetus is unclear. The aim of this study was to assess the association between COVID-19 vaccination during early pregnancy and the risk of fetal structural anomalies.This was a retrospective cohort study conducted at a single medical center in Chicago. Included were pregnant people with COVID-19 vaccination records, who completed a fetal anatomic survey between March and November 2021. Excluded were pregnancies in which fetal structural anomaly could not be assessed via ultrasound. The teratogenic window was defined as 30 days before conception until 14 weeks of gestation. Pregnant individuals who were vaccinated within this window were compared with those who were unvaccinated or vaccinated outside of the teratogenic window.A total of 3156 individuals met the inclusion criteria, with 1149 vaccinated within the teratogenic window. An anomaly was identified in 5.1% of unvaccinated people versus 4.2% of people who received at least 1 dose of vaccine ( P = 0.35). After controlling for confounders, vaccination within the teratogenic window was not associated with the presence of a fetal structural anomaly identified on ultrasound (adjusted odds ratio, 1.05; 95% confidence interval, 0.72-1.54).These preliminary findings suggest that COVID-19 vaccination was not associated with fetal structural anomalies. These findings may be useful to clinicians who counsel patients considering COVID-19 vaccination during pregnancy. EDITORIAL COMMENT(When I give a lecture on cost-effectiveness analysis, I show the cost-effectiveness quadrants that are positive and negative in costs and positive and negative in outcomes (effectiveness). Although 5 Preconception and Prenatal Care

The Legacy of the COVID-19 Pandemic: Impact on Infant and Maternal and Health from an Appalachian Academic Medical Center

“…Several authors have explored this possibility found no composite increase in anomalies in infants born to mothers who received the vaccine during the first trimester versus those who did not [25,26,27]. Additional reports about vaccine safety during the teratogenic window of gestation only considered congenital anomalies detected via ultrasonography rather than neonatal outcomes [28] allowing the possibility that more subtle anomalies not identified on ultrasound could have been missed. In our cohort during the period considered to be the COVID-19 pandemic (from September 2020 to April 2022), significantly fewer infants were born with congenital anomalies to non-COVID-19 infected mothers.…”

Pregnancy and COVID-19: past, present and future

“…An mRNA COVID-19 vaccine did not increase the risk of miscarriage in pregnant women who received the vaccine just before or during early pregnancy (<20 weeks) [83][84][85]87]. Administration of the mRNA COVID-19 vaccine during pregnancy was not associated with an increased risk of complications, including preterm birth, stillbirth, bacterial infection of the placenta, and excessive maternal blood loss after birth [85,87,88]. Furthermore, administration of COVID-19 vaccine before and during the first trimester was not associated with an increased risk of detectable birth defects [88].…”