Top 5 Takeaways

1. COVID-19 Vaccination Safety: COVID-19 vaccination during pregnancy was not associated with an increased risk of preterm birth or small-for-gestational-age (SGA) at birth.
2. Large Cohort Study: The study included over 40,000 pregnant women, providing robust data to support the findings.
3. Trimester and Dose Analysis: No increased risk was found when stratified by trimester of vaccination or number of vaccine doses received.
4. Public Health Implications: These findings support the CDC’s recommendation for COVID-19 vaccination for pregnant women to prevent severe maternal morbidity and adverse birth outcomes.
5. Vaccination Coverage: Despite the safety data, vaccination coverage among pregnant women remains low due to concerns about vaccine safety.

Original Article Author and Citation

Corresponding Author

Heather S. Lipkind, heather.lipkind@yale.edu

Suggested Citation

Lipkind HS, Vazquez-Benitez G, DeSilva M, et al. Receipt of COVID-19 Vaccine During Pregnancy and Preterm or Small-for-Gestational-Age at Birth — Eight Integrated Health Care Organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 2022;71:26–30. DOI: http://dx.doi.org/10.15585/mmwr.mm7101e1

Summary

This study evaluated the risks for preterm birth and SGA at birth among pregnant women who received COVID-19 vaccinations. The retrospective cohort included over 40,000 pregnant women from eight Vaccine Safety Datalink (VSD) health care organizations. The study found no significant association between COVID-19 vaccination during pregnancy and increased risks for preterm birth or SGA at birth. These findings support the safety of COVID-19 vaccination during pregnancy.

Methods

The study utilized a retrospective cohort design, analyzing data from eight VSD health care organizations. Pregnancies with estimated start dates or last menstrual periods during May 17–October 24, 2020, were included. The primary outcomes were preterm birth (<37 weeks’ gestation) and SGA at birth (birthweight <10th percentile for gestational age). Data on COVID-19 vaccination status, gestational age, and birthweight were collected and analyzed using Cox models with standardized inverse probability weighting to account for time-dependent vaccine exposures and propensity to be vaccinated.

Discussion

The findings indicate that COVID-19 vaccination during pregnancy does not increase the risk for preterm birth or SGA at birth. This supports the safety of COVID-19 vaccination for pregnant women. The study also highlights the importance of communicating the benefits and safety of COVID-19 vaccination during pregnancy to increase vaccine acceptance among pregnant women. Limitations include potential missed vaccinations, lack of data on certain confounders, and the small number of first-trimester vaccinations.

Conclusion

The study provides strong evidence supporting the safety of COVID-19 vaccination during pregnancy, with no increased risk for preterm birth or SGA at birth. These findings reinforce the CDC’s recommendation for COVID-19 vaccination for pregnant women to reduce the risk of severe COVID-19–associated outcomes.

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