Category: Public Health/Global Health
Poster Session IV
Maternal COVID-19 vaccination has been shown to produce a robust antibody response, but data regarding prevention of clinical disease during pregnancy is lacking. We sought to determine the impact of COVID-19 vaccination on infection rates during pregnancy and other obstetric outcomes.
Study Design:
We performed a prospective cohort study at two urban tertiary care centers enrolling COVID-19 vaccinated and unvaccinated pregnant patients. The primary outcome was the incidence of COVID-19 infection during pregnancy by positive PCR or antigen test, or by antibody testing at the beginning of pregnancy, every trimester, and delivery and was compared based on vaccination status. The secondary outcomes were gestational age at COVID-19 infection and delivery, hypertensive disorder of pregnancy, and NICU admission for the neonate. Multivariable logistic regression was used to adjust for confounders.
Results:
350 patients were enrolled, of which the majority (54.3%) were unvaccinated. The unvaccinated cohort was younger (28.9 vs 32.3 years, p< 0.01), included more patients self-identifying as Black (59.1% vs 25.3%, p< 0.01), with public insurance (53.8% vs 21.6%, p< 0.01), with a history of asthma (25.2% vs 12.4%, p< 0.01) and with prior preterm birth (5.3% vs 0.6%, p=0.01) than the vaccinated cohort (Table 1). Patients vaccinated against COVID-19 had significantly lower odds of COVID-19 infection during pregnancy (aOR 0.3, 95% CI 0.18-0.58), with similar gestational ages of infection, delivery, and rates of hypertensive disorders of pregnancy and NICU admission compared to unvaccinated patients (Table 2).
Conclusion:
Patients vaccinated against COVID-19 were 70% less likely to be infected with COVID-19 during pregnancy, complimenting the known antibody response after vaccination and underscoring its importance.
James D. Doss, MD (he/him/his)
Resident Physician
Washington University School of Medicine
St. Louis, Missouri, United States
Indira U. Mysorekar, PhD
Professor of Obstetrics, Gynecology, Infectious Disease, and Medicine
Washington University School of Medicine and Baylor College of Medicine
Houston, Texas, United States
Fan Zhang, MD, MS
Washington University School of Medicine
St. Louis, Missouri, United States
Grace Gerbi, BA
Research Assistant
Washington University School of Medicine
St. Louis, Missouri, United States
Anthony O. Odibo, MD
Professor
Washington University School of Medicine
St. Louis, Missouri, United States
Ebony B. Carter, MD, MPH (she/her/hers)
Associate Professor, MFM; Chief, Division of Clinical Resarch
Washington University School of Medicine
St. Louis, Missouri, United States
Nandini Raghuraman, MD,MSc (she/her/hers)
Assistant Professor
Barnes Jewish Hospital, Washington University in St Louis
St. Louis, Missouri, United States
Katherine H. Bligard, MA, MD
Washington University School of Medicine
St. Louis, Missouri, United States
Jeannie C. Kelly, MD,FACOG,MS
Associate Professor
Washington University School of Medicine
St. Louis, Missouri, United States