Journal ID : CJOHNS-02-10-2023-11389
[This article belongs to Volume - 54, Issue - 08]

Title : COVID-19 Vaccination in Pregnancy and Lactation: Efficacy, Safety, and Implications for Maternal-Child Health

Abstract :

The risk of preterm birth and major health issues for the mother is linked to SARS-CoV-2 infection throughout maternity. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Healthcare have both advocated for the administration of COVID-19 vaccines while expecting in response to these concerns. This advice has been established despite the original exclusion of pregnant women from vaccination trials to guarantee safety and efficacy. On the other hand, nothing is presently known about how COVID-19 vaccinations affect expectant mothers. To evaluate the efficacy and safety of COVID-19 vaccinations in patients who are pregnant. Within a single healthcare system, a comprehensive vaccination history was combined with a database of births to create a list of patients who had received vaccinations during pregnancy. To identify characteristics related to the COVID-19 vaccination, data on the mothers' sociodemographic backgrounds was examined. The Adverse Outcome Index, a composite evaluation of maternal and newborn problems, was used in the study to evaluate pregnancy and delivery outcomes. Among the 1702 patients enrolled in the delivery cohort, 100 (7.0%) decided to receive the COVID-19 vaccine during expectations, while 212 (10.6%) encountered a COVID-19 disease. The initial administration of the vaccine occurred at an average gestational age of 32 weeks (ranging from 13 weeks and 6 days to 40 weeks and 4 days). Pregnant patients who chose vaccination exhibited a diminished risk of contracting COVID-19 before childbirth (2 out of 100 [1.4%] compared to 210 out of 1602 [11.3%]; p < 0.001). Following the immunization of pregnant patients, no instances of maternal COVID-19 infection were documented. A thorough analysis employing a multivariable logistic regression model highlighted that higher age, elevated maternal education, non-smoking status, utilization of infertility therapy for the ongoing pregnancy, and lower gravidity were significantly correlated with an increased likelihood of opting for vaccination. Noteworthy differences were not observed between vaccinated and unvaccinated individuals in relation to combined adverse outcomes (7 out of 100 [5.0%] vs. 91 out of 1702 [4.9%]; p = 0.95), or in terms of additional neonatal and maternal issues such as thromboembolic events and preterm delivery. In this birth cohort, COVID-19 infection was less common in pregnant women who had received the vaccine than in those who had not, and there was no evidence that getting the vaccine during pregnancy increased the risk of pregnancy or delivery difficulties. The group was biased towards vaccination in late pregnancy, therefore results may not generalize to immunization in early pregnancy.

Full article