Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy

Smriti Prasad, Erkan Kalafat, Helena Blakeway, Rosemary Townsend, Pat O’Brien, Edward Morris, Tim Draycott, Shakila Thangaratinam, Kirsty Le Doare, Shamez Ladhani, Peter von Dadelszen, Laura A. Magee, Paul Heath and Asma Khalil ()
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Smriti Prasad: St George’s University of London
Erkan Kalafat: Middle East Technical University
Helena Blakeway: St George’s University of London
Rosemary Townsend: University of Edinburgh
Pat O’Brien: The Royal College of Obstetricians and Gynaecologists
Edward Morris: The Royal College of Obstetricians and Gynaecologists
Tim Draycott: The Royal College of Obstetricians and Gynaecologists
Shakila Thangaratinam: University of Birmingham
Kirsty Le Doare: St George’s University of London
Shamez Ladhani: Public Health England
Peter von Dadelszen: King’s College London
Laura A. Magee: King’s College London
Paul Heath: St George’s University of London
Asma Khalil: St George’s University of London

Nature Communications, 2022, vol. 13, issue 1, 1-8

Abstract: Abstract Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I2 = 73·9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0·85; 95% CI 0·73–0·99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93·9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

Date: 2022
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DOI: 10.1038/s41467-022-30052-w

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