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Journal Article Epublish 2 citations

PubMed: 40329789 DOI: 10.3346/jkms.2025.40.e63

Maternal Exposures to COVID-19 Vaccine and Adverse Birth Outcomes: National Population Study in Korea.

J Korean Med Sci 40(17):e63

Authors: Kyuwon Kim, Erdenetuya Bolormaa, Eunseon Gwak, Ju-Young Shin, Nam-Kyong Choi, Young June Choe, Seung-Ah Choe

Affiliations

  • Department of Public Health, Korea University School of Public Health, Seoul, Korea.
  • Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
  • Department of Biohealth Regulatory Science, School of Pharmacy, Sungkyunkwan University, Suwon, Korea.
  • Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul, Korea.
  • Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea.
  • Department of Public Health, Korea University School of Public Health, Seoul, Korea. Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea. Research and Management Center for Health Risk of Particulate Matter, Korea University, Seoul, Korea.

Abstract

BACKGROUND

This study aimed to estimate the association between mRNA coronavirus disease 2019 (COVID-19) vaccine exposure during pregnancy and the risks of preterm birth and congenital malformations leveraging a national population data.

METHODS

This retrospective cohort study utilized national data from the National Health Insurance System, linking maternal and infant records with COVID-19 vaccination registries. Newborns with congenital malformations were identified using diagnosis codes. The analysis included women aged 20-49 who gave live births between February 2022 and December 2022. Odds ratios (ORs) for preterm birth and any congenital malformation per COVID-19 vaccination during pregnancy compared to 1:4 matched unvaccinated controls, adjusted for maternal age, residential area, employment, income, disability, month of conception, pre-pregnancy obesity, smoking, and severe acute respiratory syndrome coronavirus 2 infection prior to pregnancy, were calculated. We compared the risk of two outcomes between BNT162b2 and mRNA-1273.

RESULTS

Among 106,692 women who gave birth during the study period, 8,966 (8.4%) received a COVID-19 vaccination during pregnancy. Of the newborns, 7,039 (6.6%) were preterm births and 7,658 (7.2%) had congenital malformations. COVID-19 vaccination during pregnancy was associated with a comparable risk of preterm birth (OR, 1.03; 95% confidence interval [CI], 0.77-1.36) and a similar risk of congenital malformations (0.90; 95% CI, 0.72-1.12) compared to non-vaccinees. The ORs of preterm birth (1.02; 95% CI, 0.77-1.36) and congenital malformation (0.91; 95% CI, 0.73-1.14) for mRNA-1273 were comparable to those for BNT162b2.

CONCLUSION

COVID-19 vaccines during pregnancy poses no increased risk of preterm birth and congenital malformations compared to those not exposed to the vaccine, with similar risk levels observed between the two mRNA vaccines. This finding provides additional evidence supporting the safety of COVID-19 vaccines.

MeSH

Congenital Abnormalities, Coronavirus, Pregnancy, Parturition, Vaccines, Covid-19 Vaccines, Vaccination, Covid-19, Premature Birth, Maternal Exposure