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Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study

Author

Listed:
  • Laura Lindsay

    (Public Health Scotland)

  • Clara Calvert

    (Usher Institute, University of Edinburgh
    London School of Hygiene and Tropical Medicine)

  • Ting Shi

    (Usher Institute, University of Edinburgh)

  • Jade Carruthers

    (Public Health Scotland)

  • Cheryl Denny

    (Public Health Scotland)

  • Jack Donaghy

    (Public Health Scotland)

  • Lisa E. M. Hopcroft

    (Public Health Scotland
    National Services Scotland)

  • Leanne Hopkins

    (Public Health Scotland)

  • Anna Goulding

    (Public Health Scotland
    Gloucestershire Hospitals NHS Foundation Trust)

  • Terry McLaughlin

    (Public Health Scotland)

  • Emily Moore

    (Public Health Scotland)

  • Bob Taylor

    (Public Health Scotland)

  • Krishnan Bhaskaran

    (London School of Hygiene and Tropical Medicine)

  • Srinivasa Vittal Katikireddi

    (Public Health Scotland
    University of Glasgow)

  • Ronan McCabe

    (University of Glasgow)

  • Colin McCowan

    (University of St Andrews)

  • Colin R. Simpson

    (Usher Institute, University of Edinburgh
    Victoria University of Wellington)

  • Chris Robertson

    (Public Health Scotland
    University of Strathclyde)

  • Aziz Sheikh

    (Usher Institute, University of Edinburgh)

  • Rachael Wood

    (Public Health Scotland
    Usher Institute, University of Edinburgh)

  • Sarah J. Stock

    (Public Health Scotland
    Usher Institute, University of Edinburgh)

Abstract

Understanding the impact of SARS-CoV-2 infection and COVID-19 vaccination in pregnancy on neonatal and maternal outcomes informs clinical decision-making. Here we report a national, population-based, matched cohort study to investigate associations between SARS-CoV-2 infection and, separately, COVID-19 vaccination just before or during pregnancy and the risk of adverse neonatal and maternal outcomes among women in Scotland with a singleton pregnancy ending at ≥20 weeks gestation. Neonatal outcomes are stillbirth, neonatal death, extended perinatal mortality, preterm birth (overall, spontaneous, and provider-initiated), small-for-gestational age, and low Apgar score. Maternal outcomes are admission to critical care or death, venous thromboembolism, hypertensive disorders of pregnancy, and pregnancy-related bleeding. We use conditional logistic regression to derive odds ratios adjusted for socio-demographic and clinical characteristics (aORs). We find that infection is associated with an increased risk of preterm (aOR=1.36, 95% Confidence Interval [CI] = 1.16–1.59) and very preterm birth (aOR = 1.90, 95% CI 1.20–3.02), maternal admission to critical care or death (aOR=1.72, 95% CI = 1.39–2.12), and venous thromboembolism (aOR = 2.53, 95% CI = 1.47–4.35). We find no evidence of increased risk for any of our outcomes following vaccination. These data suggest SARS-CoV-2 infection during pregnancy is associated with adverse neonatal and maternal outcomes, and COVID-19 vaccination remains a safe way for pregnant women to protect themselves and their babies against infection.

Suggested Citation

  • Laura Lindsay & Clara Calvert & Ting Shi & Jade Carruthers & Cheryl Denny & Jack Donaghy & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Terry McLaughlin & Emily Moore & Bob Taylor & Krishnan, 2023. "Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
  • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-40965-9
    DOI: 10.1038/s41467-023-40965-9
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    References listed on IDEAS

    as
    1. Clara Calvert & Jade Carruthers & Cheryl Denny & Jack Donaghy & Sam Hillman & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Laura Lindsay & Terry McLaughlin & Emily Moore & Jiafeng Pan & Bob , 2022. "A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection," Nature Communications, Nature, vol. 13(1), pages 1-10, December.
    2. Smriti Prasad & Erkan Kalafat & Helena Blakeway & Rosemary Townsend & Pat O’Brien & Edward Morris & Tim Draycott & Shakila Thangaratinam & Kirsty Le Doare & Shamez Ladhani & Peter von Dadelszen & Laur, 2022. "Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
    3. Clara Calvert & Jade Carruthers & Cheryl Denny & Jack Donaghy & Lisa E. M. Hopcroft & Leanne Hopkins & Anna Goulding & Laura Lindsay & Terry McLaughlin & Emily Moore & Bob Taylor & Maria Loane & Helen, 2023. "A population-based matched cohort study of major congenital anomalies following COVID-19 vaccination and SARS-CoV-2 infection," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
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