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Vaccination against COVID-19 is recommended during pregnancy, primarily to lower the risk for severe maternal infection. However, lack of data on neonatal outcomes might contribute to the suboptimal uptake of the vaccine during pregnancy.
Researchers analyzed population datasets from Norway and Sweden that included almost 200,000 infants born between June 2021 and January 2023. They compared neonatal outcomes between infants exposed to mRNA vaccination in utero (half of all infants) and unexposed infants. Most of the vaccinated women received the Pfizer BNT162B2 vaccine.
Exposure to COVID-19 vaccination in utero was not associated with higher risk for any adverse neonatal outcome. Further, it was associated with lower neonatal mortality (0.9 vs. 1.8 deaths per 1000 live births) and fewer cases of hypoxic ischemic encephalopathy (1.8 vs. 2.7 per 1000 live births) and nontraumatic intracranial hemorrhage (1.7 vs. 3.2 per 1000 live births) than was no COVID-19 vaccination.
Norman M et al. Neonatal outcomes after COVID-19 vaccination in pregnancy. JAMA 2024 Feb 6; 331:396. (https://doi.org/10.1001/jama.2023.26945)
Comment
U.S. CDC data from the 2022–2023 season showed only 27% uptake of COVID-19 vaccination during pregnancy (compared with 47% flu and 55% tetanus, diphtheria, and acellular pertussis uptake; Morb Mortal Wkly Rep 2023; 72:1065). Promoting maternal immunization is vital to reduce the unacceptably high morbidity and mortality burden from vaccine-preventable illnesses. These data should reassure patients and clinicians of the safety of COVID-19 mRNA vaccination during pregnancy.