Effectiveness and safety of COVID‐19 vaccine in pregnant women: A systematic review with meta‐analysis

Abstract

Background There are limited data regarding COVID‐19 vaccination during pregnancy. Objectives To evaluate the effects of COVID‐19 vaccination received during pregnancy on SARS‐CoV‐2 infection, COVID‐19‐related hospitalisation, COVID‐19‐related intensive care unit (ICU) admission and maternal–fetal complications. Search strategy MEDLINE, CINHAL, Embase, Scopus and CENTRAL databases, as well as ClinicalTrials.gov , reference lists, related articles and grey literature sources. Selection criteria Randomised controlled trials, non‐randomised studies of interventions, pregnant women, COVID‐19 vaccination during pregnancy. Data collection and analysis Study selection, risk‐of‐bias assessment, data extraction and assessment of the certainty of evidence using the GRADE method were performed independently by two authors. Meta‐analyses were performed using Cochrane RevMan 5.4. PROSPERO registration number: CRD42022308849. Main results We included 14 observational studies (362 353 women). The administration of a COVID‐19 vaccine during pregnancy resulted in a statistically significant reduction in SARS‐CoV‐2 infection (OR 0.46, 95% CI 0.28–0.76) and COVID‐19‐related hospitalisation (OR 0.41, 95% CI 0.33–0.51). The effect appeared to be greater in fully vaccinated women, for both infection (OR 0.31, 95% CI 0.16–0.59) and hospitalisation (OR 0.15, 95% CI 0.10–0.21). However, the certainty of evidence was very low. The difference in COVID‐19‐related ICU admission between vaccinated and unvaccinated individuals did not reach statistical significance (OR 0.58, 95% CI 0.13–2.58). Finally, there were no statistically significant differences in any of the maternal–fetal complications considered in the included studies. Conclusions COVID‐19 vaccination administered during pregnancy seems to reduce SARS‐CoV‐2 infection and COVID‐19‐related hospitalisation, with no significant effects on maternal–fetal complications.

Effectiveness and Safety of COVID-19 Vaccination During Preconceptional and Preclinical Pregnancy Period: A National Population Study

“… 24 A recent meta-analysis showed a reduction of SARS-CoV-2 infection and COVID-19-related hospitalization among fully vaccinated pregnant women. 25 The close-to-null association between SARS-CoV-2 infection and COVID-19 vaccination in our study could be due to the substantially lower incidence of ICU admission and vaccination rates in early pregnancy in South Korean pregnant women than in other populations.…”

Effectiveness of Maternal Inactivated COVID-19 Vaccination against Omicron Infection in Infants during the First 12 Months of Life: A Test-Negative Case-Control Study

“…Pregnant women were at higher risk of COVID-19-related complications than their non-pregnant counterparts [ 19 , 20 ]. To date, no significant adverse outcomes have been found in pregnant women after COVID-19 vaccination [ 21 ]. Conversely, epidemiological studies have suggested that COVID-19 vaccination of pregnant women was very effective in preventing severe SARS-CoV-2 infection and adverse pregnancy outcomes, such as spontaneous abortion, stillbirth, and premature delivery [ 22 , 23 , 24 ].…”

Impact of COVID-19 on pregnant women's health: Consequences in obstetrics two years after the pandemic

“…Some data have identified risk factors for more severe illness: Vaccination status for SARS-CoV-2 (ie below specific section) ( Tormen et al, 2023 ). As in general population: maternal age (relative risk for age > 35 years 1.42 [95 % CI, 1.13–1.8]), obesity (relative risk for BMI > 30 1.89 [95 % CI, 1.38–2.58]), or co-morbidities such as chronic cardiac or pulmonary disease, preexisting hypertension (relative risk 2.36 [95 % CI, 1.54–3.4]), diabetes mellitus (relative risk 2.12 [95 % CI, 1.27–3.25]), chronic renal disease, malignancy, and immunosuppression increase the risk of complications from COVID-19 ( Allotey et al, 2020 , McClymont et al, 2022 , Bloise et al, 2021 ).…”