COVID-19 Vaccination in the First Trimester and Major Structural Birth Defects Among Live Births.

Autor:	Kharbanda EO; HealthPartners Institute, Minneapolis, Minnesota., DeSilva MB; HealthPartners Institute, Minneapolis, Minnesota., Lipkind HS; Weill Cornell Medical College, New York, New York., Romitti PA; College of Public Health, University of Iowa, Iowa City., Zhu J; HealthPartners Institute, Minneapolis, Minnesota., Vesco KK; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon., Boyce TG; Marshfield Clinic Research Institute, Marshfield, Wisconsin., Daley MF; Institute for Health Research, Kaiser Permanente Colorado, Denver., Fuller CC; Harvard Pilgrim Health Care Institute, Boston Massachusetts., Getahun D; Kaiser Permanente Southern California and Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena., Jackson LA; Kaiser Permanente Washington Health Research Institute, Seattle., Williams JTB; Ambulatory Care Services, Denver Health, Denver, Colorado., Zerbo O; Kaiser Permanente Vaccine Study Center, Oakland, California., Weintraub ES; Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia., Vazquez-Benitez G; HealthPartners Institute, Minneapolis, Minnesota.
Jazyk:	angličtina
Zdroj:	JAMA pediatrics [JAMA Pediatr] 2024 Aug 01; Vol. 178 (8), pp. 823-829.
DOI:	10.1001/jamapediatrics.2024.1917
Abstrakt:	Importance: COVID-19 vaccination is recommended throughout pregnancy to prevent pregnancy complications and adverse birth outcomes associated with COVID-19 disease. To date, data on birth defects after first-trimester vaccination are limited. Objective: To evaluate the associated risks for selected major structural birth defects among live-born infants after first-trimester receipt of a messenger RNA (mRNA) COVID-19 vaccine. Design, Setting, and Participants: This was a retrospective cohort study of singleton pregnancies with estimated last menstrual period (LMP) between September 13, 2020, and April 3, 2021, and ending in live birth from March 5, 2021, to January 25, 2022. Included were data from 8 health systems in California, Oregon, Washington, Colorado, Minnesota, and Wisconsin in the Vaccine Safety Datalink. Exposures: Receipt of 1 or 2 mRNA COVID-19 vaccine doses in the first trimester, as part of the primary series. Main Outcomes and Measures: Selected major structural birth defects among live-born infants, identified from electronic health data using validated algorithms, with neural tube defects confirmed via medical record review. Results: Among 42 156 eligible pregnancies (mean [SD] maternal age, 30.9 [5.0] years) 7632 (18.1%) received an mRNA COVID-19 vaccine in the first trimester. Of 34 524 pregnancies without a first-trimester COVID-19 vaccination, 2045 (5.9%) were vaccinated before pregnancy, 13 494 (39.1%) during the second or third trimester, and 18 985 (55.0%) were unvaccinated before or during pregnancy. Compared with pregnant people unvaccinated in the first trimester, those vaccinated in the first trimester were older (mean [SD] age, 32.3 [4.5] years vs 30.6 [5.1] years) and differed by LMP date. After applying stabilized inverse probability weighting, differences in baseline characteristics between vaccinated and unvaccinated pregnant persons in the first trimester were negligible (standardized mean difference <0.20). Selected major structural birth defects occurred in 113 infants (1.48%) after first-trimester mRNA COVID-19 vaccination and in 488 infants (1.41%) without first-trimester vaccine exposure; the adjusted prevalence ratio was 1.02 (95% CI, 0.78-1.33). In secondary analyses, with major structural birth defect outcomes grouped by organ system, no significant differences between infants vaccinated or unvaccinated in the first trimester were identified. Conclusions and Relevance: In this multisite cohort study, among live-born infants, first-trimester mRNA COVID-19 vaccine exposure was not associated with an increased risk for selected major structural birth defects.
Databáze:	MEDLINE
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