This article first appeared on our sister site, Contemporary OB/GYN.
Neonatal outcomes do not significantly differ between newborns born to unvaccinated women compared to women who received inactivated vaccines for COVID-19 before conception, according to a recent study published in JAMA Network Open.
The World Health Organization (WHO) reported over 868,000 new cases of COVID-19 and over 3700 deaths between June 26 and July 23, 2023, making COVID-19 a continuous global health concern. COVID-19 vaccination offered protection among multiple populations during the COVID-19 pandemic, including pregnant women.
COVID-19 infection during pregnancy is associated with morbidity and mortality in mothers and infants. As COVID-19 vaccination does not increase morbidity risk, the WHO recommends pregnant women received vaccination. However, most information about vaccines is based on mRNA vaccines, with little data available on inactivated COVID-19 vaccines.
To evaluate the impact of inactivated vaccination within 3 months before conception on neonatal outcomes, investigators conducted a cohort study including all singleton live births from March 1 to June 30, 2022, at Tianjin Central Hospital of Obstetrics and Gynecology.
Newborns in the vaccinated group were born from mothers who received their initial COVID-19 dose prior to conception, while those whose mothers did not receive vaccination before or during pregnancy were in the unvaccinated group. Data on COVID-19 infection was obtained through questionnaires, and gestational age was determined by ultrasound or last menstrual period.
What You Need to Know
The study found that neonatal outcomes, including preterm birth, small for gestational age (SGA), and neonatal intensive care unit (NICU) admission, did not significantly differ between newborns born to women who received inactivated COVID-19 vaccines within 3 months before conception and those born to unvaccinated women.
The World Health Organization (WHO) reported a significant number of new COVID-19 cases and deaths between June 26 and July 23, 2023, emphasizing the continued global health concern posed by COVID-19.
The study suggests that COVID-19 vaccination does not increase the risk of adverse neonatal outcomes, and the investigators recommend that women planning for pregnancy receive the COVID-19 vaccination. This recommendation is particularly relevant for inactivated COVID-19 vaccines.
Exclusion criteria included missing consent, non-singleton birth, invalid or incomplete COVID-19 vaccine information, untargeted COVID-19 vaccine receipt, incomplete clinical information, COVID-19 vaccination more than 3 months before conception, and any dose of vaccination against COVID-19 during pregnancy.
Primary outcomes included preterm birth, small for gestational age (SGA), and neonatal intensive care unit (NICU) admission. Secondary outcomes included very preterm birth, late preterm birth, low birth weight, very low birth weight, neonatal bacterial infection, and mortality.
There were 856 neonates included in the analysis, 369 of which were in the vaccinated group. Higher education levels and rates of unplanned pregnancy were observed in the vaccination group, as well as decreased rates of assisted reproductive technology use.
Rates of preterm birth, SGA, and NICU admission did not differ between the vaccinated and unvaccinated group, even after adjusting for maternal characteristics. Very preterm birth, late preterm birth, low birth weight, very low birth weight, and neonatal bacterial infection also did not differ between groups. No cases of mortality were observed.
These results indicated COVID-19 vaccination does not impact newborn outcomes. Investigators recommended women preparing for pregnancy receive COVID-19 vaccination.
Chen Z, Mu X, Wang X, et al. Association of maternal inactivated COVID-19 vaccination within 3 months before conception with neonatal outcomes. Vaccines (Basel). 2023;11(11):1710. doi:10.3390/vaccines11111710