ABSTRACT
Background: The vaccination of COVID-19 during pregnancy has been shown to reduce maternal complications and improve fetal outcomes. Vaccinated women are less likely to experience severe illness or adverse neonatal events such as preterm birth or stillbirth. Objective: To determine the frequency of COVID-19 vaccination among pregnant women and to compare fetal outcomes between vaccinated and unvaccinated individuals.
Methods: This descriptive case-series was done at department of Obstetrics and Gynecology, Ghurki Trust Teaching Hospital, Lahore, over six months [Nov 15, 2024 till Feb 15, 2025]. A total of 379 pregnant women aged 18–45 years, booked in the third trimester, were enrolled using non-probability consecutive sampling. COVID-19 vaccination status was confirmed via vaccination cards. Participants were categorized into vaccinated and unvaccinated groups and followed until delivery. Fetal outcomes, including stillbirth, preterm birth, and low birth weight, were recorded.
Results: Out of 379 participants, 53.3% were vaccinated, with Pfizer being the most commonly administered vaccine. Stillbirth occurred in 5.8% of cases, preterm birth in 28.5%, and low birth weight in 18.7%. A significantly higher rate of stillbirth (8.4%) and low birth weight (23.3%) was observed among vaccinated women compared to unvaccinated women (2.8% and 13.6%, respectively). No significant difference in preterm birth rates was found between the two groups.
Conclusion: More than half of the pregnant participants were vaccinated against COVID-19. Nevertheless, vaccinated participants had a significantly increased rate of stillbirth and low birth weight. Additional large-scale, prospective studies should be carried out to more accurately evaluate the safety and optimal timing of COVID-19 vaccination in pregnancy.
Keywords: Antenatal care, COVID-19 vaccination, fetal outcomes, low birth weight, maternal vaccination, pregnancy, pregnancy complications, preterm birth, stillbirth, vaccine safety.