Impact of COVID-19 Vaccination on Pregnancy Outcomes among Women in Babylon City, Iraq: A Prospective Cohort Study

Abstract

Background: Maternal COVID-19 infection was associated with increased severity of adverse outcomes for birth, such as poor birth outcomes. These risks were significantly lowered by vaccination, but information on these vaccines from low- and middle-income countries such as Iraq is sparse.

Objective: To assess the impact of the maternal vaccination against COVID-19 on pregnancy outcomes in Babylon city, Iraq.

Methods: Prospective cohort study was done in Al Hashimiya General Hospital and private maternity clinics from January 2023 to December 2024. 400 pregnant women aged 18-40 were registered, 200 of whom were vaccinated (Pfizer-BioNTech or Oxford-AstraZeneca during pregnancy) and 200 of whom were not. We gathered information on demographics, obstetric history, time of vaccination, and maternal and neonatal complications. The data was analyzed using SPSS version 26.

Results: Vaccinated women had lower COVID-19 infection rates during pregnancy (8.5% vs. 34.5%; OR 0.19, 95% CI 0.11-0.33; P < 0.001). Preterm birth was also less common (9.0% vs. 16.5%; OR 0.50, 95% CI 0.28-0.89; P = 0.018). Mean gestational age was higher in vaccinated women (38.6 ± 1.4 vs. 37.8 ± 2.1 weeks; P = 0.003). Birth weight, Apgar scores, NICU admission and congenital anomalies did not differ significantly. The rates of preterm birth differed between the 3 groups of women, with the lowest rate observed among those who received second trimester vaccination (6.8%) (P = 0.04).

Conclusion: COVID-19 vaccination during pregnancy reduces maternal infection and preterm birth without increasing neonatal risks in this Iraqi population. These findings support adding COVID-19 vaccination to routine antenatal care.

Keywords:

COVID-19, vaccination, pregnancy outcomes, preterm birth, maternal health, Iraq

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