COVID-19 Vaccination During or Just Prior to Pregnancy and Hypertensive Disorders of Pregnancy.

Details

• Alternative Title:
  Vaccine, 2026, v. 75: COVID-19 Vaccination During or Just Prior to Pregnancy and Hypertensive Disorders of Pregnancy.
• Journal Article:
  Vaccine
• Personal Author:
  Sharma, Andrea J. ; Smoots, Ashley N. ; Madni, Sabrina A. ; Zauche, Lauren Head ; Waters, Ansley ; Machefsky, Aliza ; Shay, David K. ; Hinrichsen, Cameron ; Chambless, Jenna ; Norris, Kendra ; Thompson, Sarah A. ; Johnson, Tara ; Ellington, Sascha ; Olson, Christine K.
• Description:
  Hypertensive disorders of pregnancy (HDP) are leading causes of maternal and fetal morbidity/mortality. To identify potential safety concerns, we evaluated whether COVID-19 vaccination during pregnancy or within 30 days of last menstrual period was associated with self-reported HDP. We also evaluated HDP risk associated with COVID-19 illness during pregnancy. We conducted a matched cohort study using data from the Centers for Disease Control and Prevention's COVID-19 Vaccine Pregnancy Registry (C19VPR; vaccinated) and Pregnancy Risk Assessment Monitoring System (PRAMS; unvaccinated). Participants included nulliparous women with singleton pregnancies ending in livebirth (C19VPR, December 2020-March 2022; PRAMS, 2019-2021). Participants were matched by age group, race/ethnicity, and gestational age at delivery. We estimated relative risk (RR) for self-reported HDP by vaccination status using Poisson regression, adjusting for confounders. We tested for effect modification by vaccine manufacturer and vaccination timing (<20 or ≥ 20 weeks' gestation). Among matched pairs with data on self-reported COVID-19 illness in pregnancy, we estimated risk of HDP by illness status. Of 8030 eligible C19VPR participants, 8024 (99.9%) were matched to a PRAMS participant. Most C19VPR participants delivered in 2021 (98.9%); PRAMS participants delivered predominantly in 2020 (54.5%) and 2019 (17.4%). Adjusted RR for HDP was 1.24 (95% confidence interval CI: 1.08, 1.43) among C19VPR versus PRAMS participants. We observed no effect modification. Results of an analysis restricted to matched pairs who delivered in 2021 (n = 2231) were similar. Among matched pairs (n = 4039) with data on COVID-19 illness in pregnancy, adjusted RR for HDP was 1.28 (95%CI: 1.02, 1.60) for those reporting illness compared with no illness. Risk of HDP was higher among COVID-19 vaccinated compared to unvaccinated women; however, the two groups were sampled from different cohorts. Risk was similar to those who reported COVID-19 illness. Given cohort differences, the associations observed cannot be considered causal; updated assessments of HDP risks after illness and vaccination would be useful.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Pregnancy
  • COVID-19
  • Adult
  • COVID-19 Vaccines
  • Hypertension, Pregnancy-Induced
  • Vaccination
  • Pregnancy Complications, Infectious
  • Young Adult
  More +
• Keywords:
  • COVID-19
  • Hypertension
  • Pregnancy
  • Vaccination
• Source:
  Vaccine, 2026, v. 75
• DOI:
  https://doi.org/10.1016/j.vaccine.2026.128268
• ISSN:
  0264-410X ; 1873-2518
• Pubmed ID:
  41633278
• Pubmed Central ID:
  PMC12961757
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  128268 (24 pdf pages)
• Volume:
  75
• Download URL:
  https://stacks.cdc.gov/view/cdc/260803/cdc_260803_DS1.pdf
• File Type:
  [PDF - 552.09 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:2bddccb436ff0b36820f824d9be480651c6eb60605a11db20e8ebe96daac80ceb970c4946c2d3831b574f2c5d7af7cec24e26f6c6c5bd4d469fb8de17544f660