Fetal Medicine Unit, St George's Hospital, St George's University of London, London, UK.
Department of Statistics, Faculty of Arts and Sciences, Middle East Technical University, Ankara, Turkey.
Nat Commun. 2022 May 10;13(1):2414. doi: 10.1038/s41467-022-30052-w.
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, I = 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, I = 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.
妊娠期 COVID-19 疫苗的安全性和有效性是一个特别令人关注的问题，影响着这一弱势群体的疫苗接种率。在这里，我们评估了 23 项研究的证据，其中包括 117552 名接种过 COVID-19 疫苗的孕妇，这些孕妇几乎都接种了 mRNA 疫苗。我们表明，mRNA 疫苗在第二针后 7 天对 RT-PCR 确诊的 SARS-CoV-2 感染的有效性为 89.5%（95%CI 69.0-96.4%，18828 名接种过疫苗的孕妇，I=73.9%）。接种疫苗的孕妇队列中死产的风险显著降低了 15%（汇总 OR 0.85；95%CI 0.73-0.99，66067 名接种疫苗与 424624 名未接种疫苗的孕妇，I=93.9%）。没有证据表明接种疫苗会增加不良结局的风险，包括流产、出生时更早的胎龄、胎盘早剥、肺栓塞、产后出血、产妇死亡、重症监护病房入院、出生体重 Z 评分较低或新生儿重症监护病房入院（所有结局的 p>0.05）。妊娠期 COVID-19 mRNA 疫苗接种似乎是安全的，并与死产减少相关。
