(314) The association between COVID-19 vaccination during pregnancy and neonatal health outcomes

Background: Because COVID-19 vaccination is routinely advised for pregnant women, evaluation of its safety remains important. An important considered outcome in the evaluation of vaccine safety is neonatal health.

Objectives: To evaluated the association between maternal COVID-19 vaccination and neonatal health.

Methods: Data from the prospective cohort study the Dutch Pregnancy Drug Register was used. In this ongoing cohort, pregnant women self-reported their COVID-19 vaccination status and the health outcomes of their new-born child. The current study included women with a singleton live birth after at least 24 weeks gestation. Logistic regression analysis was used to study the association between COVID-19 vaccination during pregnancy and the following neonatal health outcomes; small for gestational age ( < 10th percentile birth weights according to reference norms), large for gestational age (>90th percentile birth weights according to reference norms), low Apgar score ( < 7 at 5 minutes), and neonatal health problems (breathing problems; glucose levels disturbances; low muscle tone; high muscle tension; infant jaundice requiring phototherapy; and/or (possible) infection). We corrected for various potential confounders such as demographics, maternal health, life style, and obstetric history using inverse probability of treatment weighting.

Results: In total 3742 pregnant women were included, of whom 92.1% received a COVID-19 vaccination during pregnancy. COVID-19 vaccination during pregnancy was not statistically significant associated with small for gestational age (adjusted odds ratio [aOR]=0.91; 95% confidence interval [CI]=0.60-1.38), large for gestational age (aOR=1.09; 95% CI=0.73-1.63), a low Apgar score (aOR=0.39; 95% CI=0.13-1.20), or neonatal health problems (aOR=0.83; 95% CI=0.58-1.17). The performed sensitivity analyses showed comparable results.

Conclusions: This study indicates that COVID-19 vaccination during pregnancy is not associated with adverse neonatal health outcomes. These findings contribute to the growing body of evidence on the safety of the COVID-19 vaccination during pregnancy on short-term health outcomes.