It is now well-known and well-researched in 2025 that COVID-19 infection in pregnancy can lead to adverse outcomes for maternal, infant and placental health leading to increased rates of prematurity, stillbirth and HIE.
Reducing the incidence and impact of HIE is essential, and a key part of Hope for HIE's mission and vision.
Today, the United States Secretary of Health and Human Services announced updated guidance for pregnant women and healthy children receiving COVID-19 vaccinations.
Families deserve high-quality, evidence-based care to decrease the risk of adverse impacts and outcomes that can lead to HIE, and Hope for HIE is continuing to provide high-quality information to global HIE families in order to make the best healthcare decisions between themselves and their medical providers for the highest quality of life for all.
The primary evidence that the COVID-19 vaccine is safe and effective in pregnant women worldwide for reducing prematurity, stillbirth, and hypoxic-ischemic encephalopathy comes from large population-based cohort studies and systematic reviews/meta-analyses, which consistently demonstrate that COVID-19 vaccination during pregnancy is not associated with increased risk of adverse perinatal outcomes and is associated with reductions in stillbirth, preterm birth, and hypoxic-ischemic encephalopathy.
Multiple systematic reviews and meta-analyses, including those by Prasad et al. and Watanabe et al., show that COVID-19 vaccination in pregnancy is associated with a significant reduction in stillbirth (pooled OR 0.85, 95% CI 0.73–0.99 and OR 0.73, 95% CI 0.57–0.94, respectively), without increased risk of preterm birth, small for gestational age, or neonatal intensive care unit admission.[1-2] Large cohort studies from diverse settings (e.g., Australia, Canada, Brazil, Sweden, and Norway) confirm these findings, with adjusted analyses showing lower rates of stillbirth and preterm birth among vaccinated women, and no increase in congenital anomalies or neonatal mortality.[3-6]
Specifically, a recent population-based study in Sweden and Norway found that infants born to vaccinated mothers had lower odds of hypoxic-ischemic encephalopathy (aOR 0.73, 95% CI 0.55–0.96) and neonatal mortality (aOR 0.68, 95% CI 0.50–0.91), with no increased risk of other adverse neonatal outcomes.[6] These findings are consistent across vaccine types (mRNA and inactivated), trimesters of administration, and geographic regions.[5-7]
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