The risk of pregnancy-related adverse outcomes after COVID-19 vaccination: Propensity score-matched analysis with influenza vaccination

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-11-25 DOI:10.1016/j.vaccine.2024.126506

Yu Jung Choi , Jaehun Jung , Minsun Kang , Min Joo Choi , Won Suk Choi , Yu Bin Seo , Hak-Jun Hyun , Yoonsun Yoon , Young June Choe , Geum Joon Cho , Young-Eun Kim , Dong Wook Kim , Hye Seong , Eliel Nham , Jin Gu Yoon , Ji Yun Noh , Joon Young Song , Woo Joo Kim , Hee Jin Cheong

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引用次数: 0

Abstract

Introduction

Coronavirus 2019 (COVID-19) vaccination rates in pregnant women remain low owing to safety concerns. When evaluating vaccine safety, comparisons with unvaccinated individuals may lead to healthy vaccinee bias. This study aimed to investigate the association between mRNA-based COVID-19 vaccination and pregnancy-related adverse outcomes compared with influenza vaccination.

Methods

A propensity score-matched cohort study was conducted using the National Health Insurance Service insurance claims database, combined with COVID-19 and influenza vaccination registration data from the Korea Disease Control and Prevention Agency. Based on the age, comorbidities, insurance type, region, hospital type, gestational age at vaccination, and primiparity, the COVID-19 vaccination-only group and influenza vaccination-only group were matched in a 1:3 ratio, while both (COVID-19 and influenza) vaccination group and influenza vaccination-only group were also matched in a 1:3 ratio. Logistic regression analysis was used to calculate odds ratios (ORs) with 95 % confidence intervals (CIs) between the two groups.

Results

From October 18, 2021, to March 3, 2022, 71,902 pregnant women were identified, and the vaccination records of 67,522 individuals were verified. Among them, 610 received the COVID-19 vaccination only, 49,952 received the influenza vaccination only, and 2405 received both vaccines. In the COVID-19 vaccination-only group, the risk of large for gestational age was higher than in the influenza vaccination-only group (OR = 2.285, 95 % CI = 1.155–4.522, P = 0.018). In the group that received both vaccinations, the risk of premature birth was higher (OR = 1.365, 95 % CI = 1.124–1.656, P = 0.002) than that in the influenza vaccination-only group but lower than the domestic baseline incidence rates. No significant differences were observed in other maternal and neonatal outcomes.

Conclusion

mRNA-based COVID-19 vaccination in pregnant women is safe without a remarkable increase in adverse maternal and neonatal outcomes. Given the high morbidity and mortality rates of COVID-19 in pregnant women, it is reasonable to recommend COVID-19 vaccination for pregnant women.

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接种 COVID-19 疫苗后妊娠相关不良后果的风险：与流感疫苗接种的倾向得分匹配分析

导言科罗纳病毒 2019（COVID-19）疫苗在孕妇中的接种率仍然很低，这是出于安全考虑。在评估疫苗安全性时，与未接种者进行比较可能会导致健康接种者偏差。本研究旨在调查与流感疫苗接种相比，基于 mRNA 的 COVID-19 疫苗接种与妊娠相关不良结局之间的关联。方法利用国民健康保险服务保险理赔数据库，结合韩国疾病预防控制机构提供的 COVID-19 和流感疫苗接种登记数据，进行倾向得分匹配队列研究。根据年龄、合并症、保险类型、地区、医院类型、接种时的胎龄和初产妇情况，只接种 COVID-19 疫苗组和只接种流感疫苗组按 1:3 的比例进行匹配，同时接种（COVID-19 和流感）疫苗组和只接种流感疫苗组也按 1:3 的比例进行匹配。结果从 2021 年 10 月 18 日到 2022 年 3 月 3 日，共识别出 71902 名孕妇，并核实了 67522 人的疫苗接种记录。其中，610 人只接种了 COVID-19 疫苗，49952 人只接种了流感疫苗，2405 人接种了两种疫苗。仅接种 COVID-19 疫苗组的胎龄过大风险高于仅接种流感疫苗组（OR = 2.285，95 % CI = 1.155-4.522，P = 0.018）。在同时接种两种疫苗的组别中，早产风险高于只接种流感疫苗组别（OR = 1.365，95 % CI = 1.124-1.656，P = 0.002），但低于国内基线发病率。结论孕妇接种基于 mRNA 的 COVID-19 疫苗是安全的，不会明显增加孕产妇和新生儿的不良后果。鉴于 COVID-19 在孕妇中的高发病率和高死亡率，建议孕妇接种 COVID-19 疫苗是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.