Comparison of Pregnancy and COVID-19 Complications Stratified by Maternal Vaccination Status [ID: 1363064

Abstract

INTRODUCTION: COVID-19 vaccination has been shown to reduce disease severity. However, it is unclear how vaccination status may affect complications of both pregnancy and COVID. This study aims to determine whether maternal vaccination status affects COVID-19 and pregnancy complications. METHODS: This was a retrospective study of pregnant women diagnosed with SARS-CoV-2 during the Alpha/Delta or Omicron wave (February 1, 2021 to April 1, 2022) at a single academic tertiary care center. Study was approved by the IRB. Women were divided into groups based on vaccination status. The primary outcome was COVID-19 complications (venous thromboembolism, stroke, myocardial infarction, pneumonia [PNA], acute respiratory failure [ARF], renal or hepatic failure, transaminitis). Pregnancy complications (pregnancy-induced hypertension, postpartum hemorrhage, fetal demise, preterm labor, blood transfusion, pyelonephritis, preterm prelabor rupture of membranes [PPROM]) and maternal characteristics were collected from chart review. Statistical analysis was performed using SPSS using chi-square tests and Student t tests with significance defined as P<.05. RESULTS: A total of 463 pregnant patients were included in this study. One hundred fifty-nine were fully or partially vaccinated, while 304 were not vaccinated. There was a significantly higher incidence of COVID-19 complications in patients who did not receive the vaccine (3.3%) compared to those who received the vaccine (0%) (P=.02). No patients who were vaccinated had PNA or ARF. Chronic hypertension and pregestational diabetes were also significantly associated with COVID complications. Vaccination status was not associated with any pregnancy complication. Incidence of preeclampsia without severe features was higher in vaccinated women (5.7 versus 1.6, P=.02). Of the patients who received the booster, 10.4% (5/48) had PPROM compared to 3.5% (13/372) who did not receive the booster (P<.05). CONCLUSION: Our data suggest that vaccination status is not related to obstetrical outcomes; however pregnant women who received the COVID-19 vaccine are protected from COVID-19 complications.