New support for COVID vaccine in pregnancy

A new study has found no evidence of adverse pregnancy outcomes with COVID-19 mRNA vaccines.

Pregnant women are among the groups who are under-vaccinated during the pandemic, partly due to their exclusion from initial vaccine trials leading to ambiguous guidance.

Professor Asma Khalil of St George’s, University of London, UK, and colleagues looked at the evidence from 23 studies covering 117,552 pregnant women given a COVID-19 vaccine. The vast majority received an mRNA vaccine, such as those produced by Pfizer and Moderna.

Results appeared in *Nature Communications* yesterday. The authors report: "The risk of stillbirth was significantly lower in the vaccinated cohort by 15%. 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."

They conclude that COVID-19 mRNA vaccination in pregnancy appears to be safe.

Professor Khalil said: “Our findings should help to address vaccine hesitancy in pregnant women. Although many things are returning to normal, there is still a very clear and substantial risk of COVID-19 infection for mothers and their babies, including an increased risk of premature birth and stillbirth.

"It is essential that as many people as possible receive their vaccines to reduce the risk of complications during pregnancy."

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, added: “This paper acts as further reassurance that the COVID-19 vaccine is safe in pregnancy."

Prasad, S. et al. Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. *Nature Communications* 10 May 2022; doi: 10.1038/s41467-022-30052-w

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