BACKGROUND AND PURPOSE:

• Stock et al. (Nature Medicine, 2022) describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland

METHODS:

• National, prospective dynamic pregnancy cohort
  • All ongoing and completed pregnancies in Scotland, United Kingdom, since March 1, 2020 
• Population
  • All women who were pregnant on, or became pregnant after, March 1, 2020
• Exposures
  • Infection in pregnancy
    • Infection at any point from the estimated date of conception to the date the pregnancy ends
  • Vaccination status
    • Unvaccinated
    • Partially vaccinated
    • Fully vaccinated
• Primary outcomes
  • Uptake and coverage of COVID-19 vaccination
  • COVID-19 outcomes in pregnant women

RESULTS:

• 18,457 vaccinated pregnant women
• Vaccine coverage was substantially lower in pregnant women than in the general population of reproductive aged women
  • Pregnant women: 32.3%
  • All reproductive aged women: 77.4%
• Extended perinatal mortality rate for women who gave birth within 28 days of a COVID-19 diagnosis
  • 22.6 per 1,000 births (95% CI, 12.9 to 38.5)
  • Pandemic background rate among uninfected women: 5.6 per 1,000 births (95% CI, 5.1 to 6.2)
• The majority of adverse pregnancy outcomes occurred in women who were unvaccinated
  • SARS-CoV-2 infection
    • 77.4% occurred in unvaccinated (95% CI, 76.2 to 78.6)
  • SARS-CoV-2 infection associated hospital admission
    • 90.9% occurred in unvaccinated (95% CI, 88.7 to 92.7)
  • SARS-CoV-2 infection associated critical care admission
    • 98% occurred in unvaccinated (95% CI, 92.5 to 99.7)
  • Infant deaths
    • All occurred in unvaccinated women

CONCLUSION:

• Most adverse pregnancy outcomes during the study period occurred in pregnant women who were unvaccinated and experienced SARS-CoV-2 infection during pregnancy
• The authors state

Our data support the importance of women being vaccinated in pregnancy to prevent adverse outcomes associated with COVID-19

For extended perinatal mortality, for example, we find substantially elevated rates among women who had SARS-CoV-2 within 28 d of birth; conversely, for women who had COVID-19 vaccination, extended perinatal morality rates were similar to background rates and among women with no confirmed SARS-CoV-2

Learn More – Primary Sources:

SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland

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