Findings showing that COVID-19 vaccination during pregnancy improves neonatal outcomes play a “critical role” when counseling these patients about the vaccine.
“During my rotation in obstetrics and gynecology as an intern, I saw several cases of pregnant women who had severe COVID-19 infections and had to give birth in the third trimester,” explained Dr. Atsushi Watanabe. did. “Although the newborns were negative for SARS-CoV-2, they still experienced complications such as respiratory failure and prematurity. It has also been shown that newborns may be at higher risk of NICU admission, stillbirth, premature birth, and other perinatal events compared to those who are not infected with -19.”
As a result, “we focused on neonatal and maternal outcomes.” JAMA Pediatricspointed out Dr. Atsuyuki. Together with Toshiki Kuno, M.D., FESC and FSCAI, Dr. Atsuyuki and the rest of the research team conducted a systematic review and meta-analysis of nine observational studies. Certain neonatal parameters such as preterm birth, small for gestational age, low Apgar scores, admission to the NICU, and intrauterine fetal death (IFD) acted as primary outcomes, while maternal outcome was associated with SARS-CoV-2 It served as a secondary outcome, including infection. , cesarean delivery, postpartum hemorrhage, chorioamnionitis.
Immunization reduces the risk of maternal and neonatal events
The analysis included 81,349 women who were vaccinated during pregnancy (mean age, 32-35 years) and 255,346 who were not vaccinated (mean age, 29.5-33 years). Almost all vaccinated individuals (98.2%) received the mRNA vaccine.
Six studies describe the number of doses of the COVID-19 vaccine. 52,295 of 61,255 (85.4%) received two doses of the mRNA vaccine during pregnancy. Seven studies documented the timing of first vaccination in 58,548 individuals. Nearly half (N=27,988; 47.8%) of all individuals participating in these studies received their first vaccine in the third trimester of pregnancy. Slightly fewer patients received their first injection late in pregnancy (N=27,108; 46.3%). The smallest proportion of patients (N=3,452; 5.9%) received their first dose during the first trimester.
“COVID-19 vaccination during pregnancy was associated with reduced risk of NICU admission and IFD. (Infographic)Dr. Kuno pointed out. “This is probably because vaccinated mothers are at lower risk of SARS-CoV-2 infection, and maternal SARS-CoV-2 infection may be a risk factor for worse neonatal outcomes.” COVID-19 vaccination during pregnancy is associated with an increased risk of maternal and neonatal events such as cesarean delivery, postpartum hemorrhage, chorioamnionitis, preterm birth, small size for gestational age, and decreased Apgar scores. It wasn’t related.”
Specifically, COVID-19 vaccination during pregnancy was associated with reduced risk of NICU admission (OR, 0.88; 95% CI, 0.80-0.97) and IFD (OR, 0.73; 95% CI, 0.57-0.94) and was related. Vaccination was also associated with a reduced risk of maternal SARS-CoV-2 infection (OR, 0.46; 95% CI, 0.22-0.93).
Findings establish benefits of vaccination for newborns
Doctor. Atsuyuki, Kuno, and colleagues noted the role of the findings in establishing the neonatal safety of her COVID-19 vaccination during pregnancy. This could “play a key role” in counseling pregnant patients about the teratogenic potential of the COVID-19 vaccine.
“COVID-19 vaccination during pregnancy may be associated with better neonatal outcomes without causing significant adverse effects,” said Dr. Kuno. “COVID-19 vaccination during pregnancy not only provides maternal protection against SARS-CoV-2, but may also be associated with improved neonatal outcomes. We need to balance these risks and rewards when doing so.”
The study also found that maternal protection against SARS-CoV-2 was “of utmost importance” given that most pregnant patients with COVID-19 who required intensive care were not vaccinated. said.
“Given the promising efficacy of COVID-19 vaccination in preventing maternal SARS-CoV-2 infection and the significant association between COVID-19 and neonatal/maternal outcomes, our findings suggest that It further emphasizes the importance of maternal protection against SARS-CoV-2 infection,” the researchers wrote.