Maternal and neonatal safety outcomes after SAR-CoV-2 vaccination during pregnancy: a systematic review and meta-analysis

Abstract

Background and objective More than five million individuals died because of problems connected to COVID-19. SARS-Cov-2 poses a particular challenge to expectant mothers, who comprise one of the most vulnerable segments of the population. Our aim is to demonstrate the maternal and neonatal safety of the COVID-19 vaccine during pregnancy. Methods We searched PubMed, Cochrane Library, Scopus, Web of Science (WOS), Embase, Ovid, MedRxiv, and BioRxiv databases from inception till December 2021 and then updated it in April 2022. Additionally, we searched ClinicalTrials.gov, Research Square and grey literature. Cohort, case–control studies, and randomized controlled trials detecting the safety of the Covid-19 vaccine during pregnancy were included. We used the Cochrane tool and Newcastle–Ottawa Scale to assess the risk of bias of the included studies and the GRADE scale to assess the quality of evidence. A meta-analysis was conducted using review manager 5.4. Results We included 13 studies with a total number of 56,428 patients. Our analysis showed no statistically significant difference in the following outcomes: miscarriage (1.56% vs 0.3%. RR 1.23; 95%CI 0.54 to 2.78); length of maternal hospitalization (MD 0.00; 95%CI -0.08 to 0.08); puerperal fever (1.71% vs 1.1%. RR 1.04; 95%CI 0.67 to 1.61); postpartum hemorrhage (4.27% vs 3.52%. RR 0.84; 95%CI 0.65 to 1.09); instrumental or vacuum-assisted delivery (4.16% vs 4.54%. RR 0.94; 95%CI 0.57 to 1.56); incidence of Apgar score ≤ 7 at 5 min (1.47% vs 1.48%. RR 0.86; 95%CI 0.54 to 1.37); and birthweight (MD -7.14; 95%CI -34.26 to 19.99). Conclusion In pregnancy, the current meta-analysis shows no effect of SAR-CoV-2 vaccination on the risk of miscarriage, length of stay in the hospital, puerperal fever, postpartum hemorrhage, birth weight, or the incidence of an Apgar score of ≤ 7 at 5 min.

COVID-19 vaccine hesitancy and associated factors among infertile couples undergoing assisted reproductive treatment

“…No theoretical or actual adverse effects have been prompted ( 21 – 23 ). No detrimental effects were observed among women who got vaccinated during pregnancy ( 18 – 20 ). Two recent cohorts among infertile couple in China also revealed that vaccination before ovarian stimulation had no effects on IVF outcomes ( 18 – 20 , 27 , 28 ).…”

“…No detrimental effects were observed among women who got vaccinated during pregnancy ( 18 – 20 ). Two recent cohorts among infertile couple in China also revealed that vaccination before ovarian stimulation had no effects on IVF outcomes ( 18 – 20 , 27 , 28 ). Thus, we recommended that clinicians could be more positive and encourage infertile couples with no other contradiction to take the vaccines as early as possible.…”

“…For example, pregnant women have a much lower willingness and more concerns about vaccination ( 12 – 16 ), although they have an increased risk of both maternal and fetal COVID-19 related morbidity and mortality ( 17 ). Emerging studies have been initiated to evaluate the safety and effectiveness of periconceptional vaccination on maternal and neonatal outcomes ( 18 – 20 ), as well as the effects of the COVID-19 vaccine on human fertility ( 21 – 23 ) and in vitro fertilization (IVF) treatment outcomes ( 24 – 28 ). To date, no evidence has shown that COVID-19 vaccination in the periconception or prenatal period is associated with an increased risk of reproductive health.…”

Efficacy and adverse effects of COVID-19 vaccine in pregnant women

“…Varios estudios (15,16,17,18) concuerdan con la existencia de factores adversos, pero en menor medida, refieren que los más frecuentes son dolor en el lugar de la inyección, fiebre, malestar general, artralgia, dolor de cabeza, que fueron más comunes luego de la segunda vacunación.…”

“…Hagrass y col. (17) 2022 Resultados de seguridad materna y neonatal después de la vacunación SAR-CoV-2 durante el embarazo: una revisión sistemática y metaanálisis.…”