We aimed to estimate the associations between coronavirus disease 2019 (COVID-19) vaccination during pregnancy and the risks of adverse perinatal outcomes. We performed a literature search in PubMed, Web of Science and Embase to identify eligible studies published up to 24 September 2023, yielding 39 included studies. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random effects model. The pooled results showed that COVID-19 vaccination during pregnancy (any type or dose of COVID-19 vaccination during any trimester) was not associated with an increased risk of adverse perinatal outcomes. In particular, COVID-19 vaccination in the third trimester was associated with a decreased risk of preterm birth (<37 weeks) (RR 0.85 [95% CI 0.74 to 0.98]), 5-min Apgar <7 (RR 0.87 [95% CI 0.78 to 0.97]) and neonatal intensive care unit (NICU) admission (RR 0.90 [95% CI 0.86 to 0.95]). The inverse associations were also found in analysis of one-dose vaccination during pregnancy and the risk of miscarriage (RR 0.83 [95% CI 0.72 to 0.96]) and preterm birth (<37 weeks) (RR 0.90 [95% CI 0.80 to 1.00]) and two-dose vaccination during pregnancy and the risk of NICU admission (RR 0.86 [95% CI 0.76 to 0.96]). COVID-19 vaccination during pregnancy does not increase the risk of negative outcomes for the mother or baby.

中文翻译：

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怀孕期间的 COVID-19 疫苗接种和不良围产期结局：系统评价和荟萃分析

我们的目的是评估怀孕期间接种 2019 年冠状病毒病 (COVID-19) 疫苗与不良围产期结局风险之间的关联。我们在 PubMed、Web of Science 和 Embase 中进行了文献检索，以确定截至 2023 年 9 月 24 日发表的符合条件的研究，产生了 39 项纳入研究。使用随机效应模型计算具有 95% 置信区间 (CI) 的汇总相对风险 (RR)。汇总结果显示，怀孕期间接种 COVID-19 疫苗（在任何三个月期间接种任何类型或剂量的 COVID-19 疫苗）与不良围产期结局风险增加无关。特别是，妊娠晚期接种 COVID-19 疫苗与早产风险降低相关（<37 周）（RR 0.85 [95% CI 0.74 至 0.98]），5 分钟 Apgar <7（RR 0.87 [ 95% CI 0.78 至 0.97]）和新生儿重症监护室 (NICU) 入院（RR 0.90 [95% CI 0.86 至 0.95]）。在怀孕期间一剂疫苗接种的分析中也发现了负相关关系，即流产风险（RR 0.83 [95% CI 0.72 - 0.96]）和早产风险（<37 周）（RR 0.90 [95% CI 0.80 - 0.96]） 1.00]）和怀孕期间两剂疫苗接种以及 NICU 入住风险（RR 0.86 [95% CI 0.76 至 0.96]）。怀孕期间接种 COVID-19 疫苗不会增加母亲或婴儿出现不良后果的风险。