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

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 Bhaskaran; Srinivasa Vittal Katikireddi; Ronan McCabe; Colin McCowan; Colin R Simpson; Chris Robertson; Aziz Sheikh; Rachel Wood; Sarah J Stock

doi:10.1038/s41467-023-40965-9

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

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 Bhaskaran, Srinivasa Vittal Katikireddi, Ronan McCabe, Colin McCowan^*, Colin R Simpson, Chris Robertson, Aziz Sheikh, Rachel Wood^*Sarah J Stock

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

10 Downloads (Pure)

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.

Original language	English
Article number	5275
Number of pages	13
Journal	Nature Communications
Volume	14
DOIs	https://doi.org/10.1038/s41467-023-40965-9
Publication status	Published - 29 Aug 2023

Keywords

COVID-19

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1038/s41467-023-40965-9Licence: CC BY

Lindsay-2023-Neonatal-and-maternal-NatComms-CCBY
Copyright © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Final published version, 1.09 MBLicence: CC BY

Cite this

Lindsay, L., Calvert, C., Shi, T., Carruthers, J., Denny, C., Donaghy, J., Hopcroft, L. E. M., Hopkins, L., Goulding, A., McLaughlin, T., Moore, E., Taylor, B., Bhaskaran, K., Katikireddi, S. V., McCabe, R., McCowan, C., Simpson, C. R., Robertson, C., Sheikh, A., ... Stock, S. J. (2023). Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study. Nature Communications, 14, Article 5275. https://doi.org/10.1038/s41467-023-40965-9

@article{3350f1a2889741fc97a3accc957debb4,

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

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.",

keywords = "COVID-19",

author = "Laura Lindsay and Clara Calvert and Ting Shi and Jade Carruthers and Cheryl Denny and Jack Donaghy and Hopcroft, {Lisa E M} and Leanne Hopkins and Anna Goulding and Terry McLaughlin and Emily Moore and Bob Taylor and Krishnan Bhaskaran and Katikireddi, {Srinivasa Vittal} and Ronan McCabe and Colin McCowan and Simpson, {Colin R} and Chris Robertson and Aziz Sheikh and Rachel Wood and Stock, {Sarah J}",

note = "Funding: COPS is a sub-study of EAVE II, which is funded by the Medical Research Council (MC_PC_19075) with the support of BREATHE – The Health Data Research Hub for Respiratory Health [MC_PC_19004], which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Additional support has been provided through Public Health Scotland and Scottish Government DG Health and Social Care and the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. COPS has received additional funding from Tommy{\textquoteright}s charity. SJS is funded by a Wellcome Trust Clinical Career Development Fellowship (209560/Z/17/Z). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17).",

year = "2023",

month = aug,

day = "29",

doi = "10.1038/s41467-023-40965-9",

language = "English",

volume = "14",

journal = "Nature Communications",

issn = "2041-1723",

publisher = "Nature publishing group",

}

Lindsay, L, Calvert, C, Shi, T, Carruthers, J, Denny, C, Donaghy, J, Hopcroft, LEM, Hopkins, L, Goulding, A, McLaughlin, T, Moore, E, Taylor, B, Bhaskaran, K, Katikireddi, SV, McCabe, R, McCowan, C, Simpson, CR, Robertson, C, Sheikh, A, Wood, R & Stock, SJ 2023, 'Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study', Nature Communications, vol. 14, 5275. https://doi.org/10.1038/s41467-023-40965-9

TY - JOUR

T1 - Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination

T2 - a population-based matched cohort study

AU - Lindsay, Laura

AU - Calvert, Clara

AU - Shi, Ting

AU - Carruthers, Jade

AU - Denny, Cheryl

AU - Donaghy, Jack

AU - Hopcroft, Lisa E M

AU - Hopkins, Leanne

AU - Goulding, Anna

AU - McLaughlin, Terry

AU - Moore, Emily

AU - Taylor, Bob

AU - Bhaskaran, Krishnan

AU - Katikireddi, Srinivasa Vittal

AU - McCabe, Ronan

AU - McCowan, Colin

AU - Simpson, Colin R

AU - Robertson, Chris

AU - Sheikh, Aziz

AU - Wood, Rachel

AU - Stock, Sarah J

N1 - Funding: COPS is a sub-study of EAVE II, which is funded by the Medical Research Council (MC_PC_19075) with the support of BREATHE – The Health Data Research Hub for Respiratory Health [MC_PC_19004], which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Additional support has been provided through Public Health Scotland and Scottish Government DG Health and Social Care and the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. COPS has received additional funding from Tommy’s charity. SJS is funded by a Wellcome Trust Clinical Career Development Fellowship (209560/Z/17/Z). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17).

PY - 2023/8/29

Y1 - 2023/8/29

N2 - 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.

AB - 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.

KW - COVID-19

U2 - 10.1038/s41467-023-40965-9

DO - 10.1038/s41467-023-40965-9

M3 - Article

SN - 2041-1723

VL - 14

JO - Nature Communications

JF - Nature Communications

M1 - 5275

ER -

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

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this