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

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...

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Bibliographic Details
Published in:Nature communications Vol. 14; no. 1; pp. 5275 - 13
Main Authors: Lindsay, Laura, Calvert, Clara, Shi, Ting, Carruthers, Jade, Denny, Cheryl, Donaghy, Jack, Hopcroft, Lisa E. M., Hopkins, Leanne, Goulding, Anna, McLaughlin, Terry, Moore, Emily, Taylor, Bob, Bhaskaran, Krishnan, Katikireddi, Srinivasa Vittal, McCabe, Ronan, McCowan, Colin, Simpson, Colin R., Robertson, Chris, Sheikh, Aziz, Wood, Rachael, Stock, Sarah J.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 29.08.2023
Nature Publishing Group
Nature Portfolio
Subjects:
631/326/590
631/326/596/4130
692/308/174
692/699/255
Adult
Apgar score
Birth
Childbirth & labor
Cohort analysis
Cohort Studies
Confidence intervals
COVID-19
COVID-19 - pathology
COVID-19 vaccines
COVID-19 Vaccines - adverse effects
Critical care
Death
Decision making
Female
Gestational age
Humanities and Social Sciences
Humans
Immunization
Infant, Newborn
Infections
Mortality
multidisciplinary
Neonates
Population studies
Population-based studies
Pregnancy
Pregnancy Complications, Infectious - pathology
Pregnancy Outcome
Premature birth
Risk
Science
Science (multidisciplinary)
Severe acute respiratory syndrome coronavirus 2
Small for gestational age
Statistical analysis
Thromboembolism
Vaccination
United Kingdom > UK
Scotland
ISSN:2041-1723, 2041-1723
Online Access:Get full text
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Summary: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. The impacts of SARS-CoV-2 infection and COVID-19 vaccination in pregnancy are not fully understood. Here, the authors perform a cohort study using data from Scotland and find that infection was associated with increased risk of preterm birth and some adverse maternal outcomes, but there was no evidence of adverse outcomes associated with vaccination.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-023-40965-9