Study Results Support COVID-19 Vaccination in Pregnant Women With Rheumatic Disease

Vaccination against COVID-19 is recommended in patients with rheumatic and musculoskeletal diseases (RMDs) who are pregnant or considering pregnancy, according to research results presented at the American College of Rheumatology (ACR) Convergence 2022, held from November 10 to 14, in Philadelphia, Pennsylvania.

Researchers collected data from the COVID-19 Global Rheumatology Alliance registry to evaluate obstetric outcomes, based on COVID-19 vaccination status, in pregnant women with RMDs and COVID-19. .

Pregnant patients who were enrolled in the registry between March 2020 and February 2022 were eligible for inclusion in the study. Obstetric outcomes were stratified by vaccination status. Outcomes were compared between partially vaccinated or unvaccinated patients and fully vaccinated (≥2 doses) patients.

Data from 73 pregnancies in 73 women with RMDs and COVID-19 were included in the analysis. Mean patient age at the time of registry entry was 32.3 (SD, 5.1) years. The most common RMD diagnoses were systemic lupus erythematosus (23.3%) and rheumatoid arthritis (21.9%).

A total of 69.9% of patients achieved RMD remission during their COVID-19 diagnosis, with 4.1% reporting severe RMD activity. The majority of pregnancies (90.9%) resulted in live births; 1 miscarriage, 1 termination, and 3 stillbirths were recorded. At the time of COVID-19 diagnosis, 60.3% of patients were unvaccinated; 4.1% were partially vaccinated; and 35.6% had received 2 or more vaccine doses. A total of 15 pregnant women (20.5%) were hospitalized for COVID-19 and 12 (16.4%) required pharmacologic treatment for the resolution of COVID-19.

COVID-19 resulted in delivery in 3 unvaccinated patients and 1 fully vaccinated patient. Of the completed pregnancies, a greater proportion of preterm births were observed in unvaccinated vs fully vaccinated women (29.5% vs 18.2%, respectively). The most common complications were low birth weight and small-for-gestational-age, which occurred in 24% and 14% of completed pregnancies, respectively.

Overall, pharmacologic treatment for COVID-19 was rarely required in pregnant women with RMD, regardless of vaccination status. However, preterm births were more common in the COVID-19-unvaccinated vs fully vaccinated population.

“These results support active promotion of COVID-19 vaccination of women with RMD who are pregnant or planning a pregnancy,” the study authors noted.

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.