Safety unveiled: COVID-19 vaccination in pregnancy and the reassuring truth about its impact on the risk of preterm birth

Amid the uncertainties of the Covid-19 pandemic, concerns about the safety and efficacy of vaccination during pregnancy, specifically in relation to preterm birth, took centre stage. A systematic review comprising six studies with more than 35,000 patients from diverse geographical locations aims to shed light on the safety of Covid-19 vaccination during pregnancy. The analysis reveals no significant increase in the risk of preterm birth after vaccination. These findings provide reassuring guidance for healthcare providers and expectant mothers, challenging prevailing concerns and advocating for the incorporation of Covid-19 vaccines into pregnancy-related public health strategies.

When it comes to disease and vaccine risk, pregnant women are particularly vulnerable and need additional information and reassurance compared to other population groups. During the Covid-19 pandemic, infected pregnant women became more severely ill than non-pregnant women and had a higher risk of Covid-19 complications. In addition, their Covid-19 infection increased the risk of adverse pregnancy outcomes, including a higher rate of stillbirths and a 50% higher risk of preterm birth (PTB). Pregnant women have an altered immune response that follows the physiological changes during pregnancy and makes them more susceptible to infections and their outcomes. This vulnerability highlights the need to assess whether Covid-19 vaccines can help protect pregnant women from infection with the virus and thus effectively prevent the increased risk of preterm birth.

For this reason, a total of 35,612 women from six cohort studies were examined. The participants originated from Israel, Romania, and the USA, which represents a very diverse study population. A range of different Covid-19 vaccines were used, and the women were vaccinated with up to two doses.

Covid-19 vaccination does not increase the risk of PTB

Even though the data varied between the different cohorts, the vaccination did not significantly increase the risk of PTB. The cohorts based in Israel even showed that a Covid-19 vaccination reduced the risk of major heart malfunctions and combined adverse neonatal outcomes. The Covid-19 vaccination therefore has the potential to protect mother and newborn from infection-related health problems.

However, the study concludes that due to the individual risk factors of the mother, the decision to vaccinate during pregnancy should be customised to the pregnant woman, taking into account the type and dosage of the vaccine. In addition, the study authors highlight the need for more surveillance and research on Covid-19 vaccines in pregnancy to support informed vaccination decision-making.

A mother’s antibodies can protect the newborn even after birth

Surprisingly, the study reveals that the potential of the Covid-19 vaccination is greater than only protecting the pregnant women’s health from severe infections and complications. If the mother is vaccinated, the antibodies are transferred via the umbilical cord to the foetus, which may also confer immunity to the infant. Since children under the age of two cannot be vaccinated, this contributes greatly to the protection of the infants, as neonates are at increased risk of severe Covid-19 illness. Even after birth, antibodies from the mother can be transferred to the child via breast milk.

These outcomes therefore reassure healthcare professionals and expectant mothers about the safety of Covid-19 vaccination during pregnancy.

Paper available at: https://www.mdpi.com/2076-393X/12/1/102

Ful list of authors: Mihaela Uta, Marius Craina, Felicia Marc, Ileana Enatescu

DOI: https://doi.org/10.3390/vaccines12010102

Learn more about the risk of Covid-19 for preterm infants here , and about the care for newborns impacted by Covid-19 here and here