COVID-19 vaccination during pregnancy was linked to a lower risk of neonatal intensive care unit (NICU) admission, stillbirth, and maternal SARS-CoV-2 infection and no additional risk of preterm birth, small for gestational age (SGA), low Apgar score, cesarean delivery, postpartum hemorrhage, or chorioamnionitis, finds a systematic review and meta-analysis published yesterday in JAMA Pediatrics.

Japanese researchers led the analysis of nine observational studies comparing the pregnancy outcomes of 81,349 women who received at least one COVID-19 vaccine dose with those of 255,346 unvaccinated peers through Apr 5, 2022. Average age was 32 to 35 years in the vaccinated group and 29.5 to 33 years in the unvaccinated group.

Among vaccinated women, 98.2% had received an mRNA vaccine (Pfizer/BioNTech, Moderna, or unstipulated), while 1.1% received a viral vector vaccine (Oxford/AstraZeneca or Johnson & Johnson), and 0.7% were undocumented.

In the six studies that reported the number of doses, 85.4% of women received two doses of an mRNA vaccine. Seven studies reported the timing of the first dose, with 5.9%, 46.3%, and 47.8% of women receiving their first dose during the first, second, and third trimester, respectively.

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