(493) COVID-19 vaccination status and association with congenital anomalies and birthweight

Despite recommendations for COVID-19 vaccination in pregnant people, the effect of vaccination on neonatal outcomes remains unknown. We sought to determine the association between COVID vaccination status, presence of congenital anomalies, and birthweight.

Study Design:

A comprehensive vaccine registry was combined with a delivery database to create a cohort including all patients aged 16-55 years with a delivery event between December 10, 2020 and December 31, 2021 at a hospital within the Mayo Clinic Health System.  Pregnancy and neonatal outcomes were analyzed in relation to vaccination status and timing, including a composite measure of congenital anomalies and birthweight by gestational age.  

Comparisons between cohorts were conducted using chi-square test for categorical and Kruskal Wallis test for continuous variables. A multivariable and multinomial logistic regression was modeled to assess the association with congenital anomalies and birthweight, respectively. 

Results:

5188 mother-infant pairs were analyzed. A total of 3,938 were vaccinated, with 320 vaccinated in the first trimester. Vaccinated pregnant people were significantly older, more likely to be White non-Hispanic, and more likely to have chronic hypertension. They were also significantly less likely to be obese or have substance use disorder.  We found no difference between groups regarding development of gestational diabetes, gestational hypertension, and preeclampsia.   

There were no significant differences when examining infant characteristics by vaccinated, unvaccinated, or first trimester vaccination groups. The presence of congenital anomalies was similar across all groups even when stratified by organ system. No differences were found in infant APGAR score, birthweight, chromosomal abnormalities, NICU admission, and living status across groups.  

Conclusion:

COVID-19 vaccination during pregnancy was not associated with a difference in birthweight, APGAR scores, NICU admission, or presence of congenital anomalies.  These findings are reassuring with respect to safety of COVID-19 vaccination during any trimester of pregnancy.