Pregnancy outcomes following natural conception and assisted reproduction treatment in women who received COVID-19 vaccination prior to conception: a population-based cohort study in China

Yulu Yang; Yujie Dong; Guojing Li; Biqi Yin; Xiong Tang; Liangfang Jia; Xueke Zhang; Wenjuan Yang; Chao Wang; Xiaoqing Peng; Ying Zhang; Yunxia Cao; Xiaofeng Xu

doi:10.3389/fmed.2023.1250165

Pregnancy outcomes following natural conception and assisted reproduction treatment in women who received COVID-19 vaccination prior to conception: a population-based cohort study in China

Front Med (Lausanne). 2023 Oct 11:10:1250165. doi: 10.3389/fmed.2023.1250165. eCollection 2023.

Authors

Yulu Yang^{1

2

3}, Yujie Dong^{1

2

3}, Guojing Li^{1

2

3

4}, Biqi Yin^{1

2

5}, Xiong Tang^{1

2

3}, Liangfang Jia⁴, Xueke Zhang^{1

6

7

8}, Wenjuan Yang^{1

6

7}, Chao Wang^{1

2

3

8}, Xiaoqing Peng^{1

2

3

8}, Ying Zhang^{1

2

3}, Yunxia Cao^{1

2

3}, Xiaofeng Xu^{1

2

3}

Affiliations

¹ Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
² NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), Hefei, China.
³ Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
⁴ Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, China.
⁵ Department of Obstetrics and Gynecology, The Hefei First People's Hospital, Hefei, China.
⁶ Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China.
⁷ Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, Hefei, China.
⁸ Anhui Provincial Institute of Translational Medicine, Hefei, China.

Abstract

Introduction: The coronavirus disease-2019 (COVID-19) pandemic has swept across the world and continues to exert serious adverse effects on vulnerable populations, including pregnant women and neonates. The vaccines available at present were designed to prevent infection from COVID-19 strains and control viral spread. Although the incidence of pregnancy cycle outcomes are not likely to increase patients vaccinated prior to pregnancy compared with unvaccinated patients based on our knowledge of vaccination safety, there is no specific evidence to support this hypothesis. Therefore, the current study aimed to investigate the association between maternal vaccination prior to conception and pregnancy outcomes.

Methods: We retrospectively analyzed 2,614 women who received prenatal care and delivered in the Obstetrical Department of The First Affiliated Hospital of Anhui Medical University between February 2022 and November 2022. Of the 1,380 eligible pregnant women, 899 women who had received preconception vaccination were assigned to a vaccine group and 481 women who were not vaccinated were control group. Of the enrolled patients, 291 women received fertility treatment (141 vaccinated women, 150 unvaccinated women). The primary outcomes were pregnancy complications (hypothyroidism, gestational diabetes mellitus, pregnancy-induced hypertension, polyhydramnios, oligohydramnios, premature rupture of membranes and postpartum hemorrhage), obstetric outcomes (preterm birth rate, cesarean section rate) and neonatal outcomes (birth-weight, body length, low-birth-weight rate, rate of congenital defects, neonatal mortality and admission to the neonatal intensive care unit).

Results: There was no significant difference in the incidence of complications during pregnancy and delivery when compared between the vaccine group and control group in either univariate- or multivariate-models. The type of vaccine was not associated with the odds of adverse pregnancy outcome. Among the women with infertility treatment, the vaccinated group and the unvaccinated group had similar pregnancy outcomes.

Conclusion: Women who received COVID-19 vaccination prior to conception had similar maternal and neonatal outcomes as women who were unvaccinated. Our findings indicate that COVID-19 vaccinations can be safely administered prior to pregnancy in women who are planning pregnancy or assisted reproductive treatment. During new waves of COVID-19 infection, women who are planning pregnancy should be vaccinated as soon as possible to avoid subsequent infections.

Keywords: COVID-19; neonatal outcomes; obstetric outcomes; safety; vaccination.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2019PT310002) and Quality Engineering Project Fund of Anhui Province (2021jyxm0721).