Adverse Pregnancy Outcomes Following COVID-19 Infection or Vaccination in Active Component U.S. Military Service Women, 2021–2023

Prior studies have found a higher risk of adverse pregnancy outcomes due to COVID-19 infection; however, recent literature documents few adverse impacts to younger and otherwise healthy populations, but with limited information about military members. The study population comprised active component service women with a singleton delivery between 2021 and 2023. Adverse pregnancy outcomes were evaluated by COVID-19 infection and vaccination history, as well as by demographics and pre-existing comorbidities. During the surveillance period, 39,355 active component U.S. service women had a singleton delivery. After controlling for potential confounders in the adjusted logistic regression analysis, COVID-19 infection during pregnancy was associated with eclampsia (OR 2.18, p<0.05) and antepartum hemorrhage (OR 1.11, p<0.05), and COVID-19 infection prior to the start of pregnancy was associated with antepartum hemorrhage (OR 1.18, p<0.05). In comparison, after adjustment, COVID-19 vaccination during pregnancy and prior to start of pregnancy was not associated with increased odds of any adverse pregnancy outcome in active component service women. COVID-19 vaccines are recommended for pregnant women by the American College of Obstetricians and Gynecologists and, previously, the U.S. Centers for Disease Control and Prevention.