Sylvia Fernandez-Garcia, Laura del Campo-Albendea, Darshini Sambamorti, Jameela Sheikh, Karen Lau, Nana Osei-Rah, Anushka Ramkumar, Harshita Naidu, Nicole Stoney, Paul Sundaram, Paulomi Sengupta, Samay Mehta, Shruti Atalde, Sophie Maddock, Millie Manning, Zainita Meherary, Kekashan Ansari, Heidi Lawson, Magnus Yap, Tania Kew, Andrija Pnuth, Chloe Knight, Eina Sadeka , Jiya Cherian, Sanghamitra Ravi, Wenting Chen, Kate Walker, Keelin O’Donoghue, Madelon van Werie, Elizabeth van Leeuwen, Elena Kostova, Heinke Kunst, Asma Khalil, Vanessa Brizuela, Edna Kara, Caron Rahn Kim, Anna Thorson, Olufemi T. Oladapo, Lynn Moffensson, Sami L. Gottlieb, Mercedes Bonnet, Ngawai Moss, Javier Zamora, John Allotey, Shakira Tangarati Namu
abstract
objective To assess the impact of the novel coronavirus vaccine on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes in pre- or pregnant women.
design Systematic review and meta-analysis.
data source Main databases from December 2019 to January 2023.
Research selection Nine reviewers contributed to study selection. We included test-negative designs, comparison cohorts, and randomized trials of the effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Noncomparative cohort studies reporting reactogenicity results were also included.
Quality assessment, data extraction and analysis Two reviewers independently assessed study quality and extracted data. We conducted a random effects meta-analysis and reported results as HR, risk ratio (RR), OR, or percentage with 95% CI.
result Sixty-seven studies (1,813,947 women) were included. Overall, in test-negative design studies, pregnant women who were fully vaccinated against COVID-19 had a 61% reduced odds of acquiring SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23,927 women; I2=87.2%); 94% reduced odds of hospitalization (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2= 92%). In an adjusted cohort study, the risk of hypertensive disorders during pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92, 2 studies, 115,085 women) and caesarean section was reduced by 9% ( OR 0.91, 95%). CI 0.85 to 0.98, 6 studies, 30,192 women). An 8% reduced risk of neonatal intensive care unit admission was observed for infants born to vaccinated women compared to unvaccinated women (RR 0.92, 95% CI 0.87 to 0.97, 2 studies, 54,569 women). In general, vaccination during pregnancy was not associated with an increased risk of adverse pregnancy or perinatal outcomes. Injection site pain was the most common side effect reported (77%, 95% CI 52% to 94%, 11 studies, 27,195 women).
conclusion COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women.
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