BNT162b2 COVID-19 vaccination during pregnancy is not associated with adverse neonatal outcomes

Reference

Goldshtein I, Steinberg DM, Kuint J, et al. Association of BNT162b2 COVID-19 vaccination during pregnancy with neonatal and early infant outcomes. JAMA Pediatr 2022;176(5):470-477.

Synopsis

These authors identified a cohort of 24,288 singleton births in Israel from March 1, 2021, through September 31, 2021. A total of 16,697 of the newborns were exposed in utero to the Pfizer-BioNTech COVID vaccine. The authors used propensity scores to adjust for maternal age, timing of conception, parity, socioeconomic status, population subgroup, and maternal influenza immunization status. They had less than 6 months of follow-up on the infants. The authors identified no difference in the rate of preterm births (relative risk [RR] = 0.95; 95% CI 0.83 - 1.10), rate of small for gestational age (RR = 0.97; 0.87 - 1.08), or neonatal hospitalizations (RR = 0.99; 0.88 - 1.12). While congenital anomalies were less frequent in the infants exposed to the vaccine, the absolute number of infants with anomalies was low (RR = 0.69; 0.44 - 1.04). Finally, receipt of the vaccine was associated with a lower risk of delivery before 32 weeks' (RR 0.45; 0.29 - 0.70) and very low birth weight (< 1500 grams; RR 0.41; 0.26 - 0.65). Although encouraging, the data are still inadequate to identify rare events.