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. 2022 Oct 17;13(1):6124.
doi: 10.1038/s41467-022-33937-y.

A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection

Clara Calvert  1   2 , Jade Carruthers  3 , Cheryl Denny  3 , Jack Donaghy  3 , Sam Hillman  3 , Lisa E M Hopcroft  3   4 , Leanne Hopkins  3 , Anna Goulding  3 , Laura Lindsay  3 , Terry McLaughlin  3 , Emily Moore  3 , Jiafeng Pan  5 , Bob Taylor  3 , Fatima Almaghrabi  1 , Bonnie Auyeung  6 , Krishnan Bhaskaran  2 , Cheryl L Gibbons  3 , Srinivasa Vittal Katikireddi  3   7 , Colin McCowan  8 , Josie Murray  3   8 , Maureen O'Leary  3 , Lewis D Ritchie  9 , Syed Ahmar Shah  1 , Colin R Simpson  3   10 , Chris Robertson  3   5 , Aziz Sheikh  1 , Sarah J Stock #  11   12 , Rachael Wood #  1   3
Affiliations

A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection

Clara Calvert et al. Nat Commun. .

Abstract

Data on the safety of COVID-19 vaccines in early pregnancy are limited. We conducted a national, population-based, matched cohort study assessing associations between COVID-19 vaccination and miscarriage prior to 20 weeks gestation and, separately, ectopic pregnancy. We identified women in Scotland vaccinated between 6 weeks preconception and 19 weeks 6 days gestation (for miscarriage; n = 18,780) or 2 weeks 6 days gestation (for ectopic; n = 10,570). Matched, unvaccinated women from the pre-pandemic and, separately, pandemic periods were used as controls. Here we show no association between vaccination and miscarriage (adjusted Odds Ratio [aOR], pre-pandemic controls = 1.02, 95% Confidence Interval [CI] = 0.96-1.09) or ectopic pregnancy (aOR = 1.13, 95% CI = 0.92-1.38). We undertook additional analyses examining confirmed SARS-CoV-2 infection as the exposure and similarly found no association with miscarriage or ectopic pregnancy. Our findings support current recommendations that vaccination remains the safest way for pregnant women to protect themselves and their babies from COVID-19.

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Conflict of interest statement

A.S. and C.R. were members of the Scottish Government’s COVID-19 Advisory Group. A.S. and C.R. are members of the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) risk stratification subgroup and the Scottish Government’s Committee on Pandemic Preparedness. C.R. is a member of the Scientific Pandemic Influenza Group on Modelling. A.S. is a member of AstraZeneca’s Thrombotic Thrombocytopenic Advisory Group. All roles are unremunerated. S.V.K. was co-chair of Scottish Government’s Expert Reference Group on Ethnicity and COVID-19. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Selection of vaccinated and unvaccinated pregnancy cohorts for miscarriage outcome analysis.
Flow diagram showing the selection of pregnancies for the analysis of the association between COVID-19 vaccination and risk of miscarriage. *For miscarriage analysis, vaccination needs to be given between 6 weeks preconception and up to the earliest of (1) end of pregnancy or (2) 19 weeks 6 days gestation.
Fig. 2
Fig. 2. COVID-19 vaccination between 6 weeks preconception and 19 weeks and 6 days gestation over time.
Line graph showing the total number of women vaccinated between 6 weeks preconception and up to 19 weeks and 6 days gestation by calendar time, dose number and type of vaccine.
See this image and copyright information in PMC

References

    1. Dagan N, et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat. Med. 2021;27:1693–1695. doi: 10.1038/s41591-021-01490-8. - DOI - PubMed
    1. Goldshtein I, et al. Association between BNT162b2 vaccination and incidence of SARS-CoV-2 infection in pregnant women. JAMA. 2021;326:728–735. doi: 10.1001/jama.2021.11035. - DOI - PMC - PubMed
    1. Stock, S. J. et al. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland. Nat. Med.28, 504–512 (2022). - PMC - PubMed
    1. UK Health Security Agency. COVID-19 Vaccine Surveillance Report—Week 19 (UK Health Security Agency, accessed 10 June 2022); https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (2022).
    1. Public Health Scotland. COVID-19 Statistical Report—11 May 2022 (Public Health Scotland, accessed 10 June 2022); https://www.publichealthscotland.scot/publications/covid-19-statistical-... (2022).

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