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

Calvert, Clara and Carruthers, Jade and Denny, Cheryl and Donaghy, Jack and Hillman, Sam and Hopcroft, Lisa E. M. and Hopkins, Leanne and Goulding, Anna and Lindsay, Laura and McLaughlin, Terry and Moore, Emily and Pan, Jiafeng and Taylor, Bob and Almaghrabi, Fatima and Auyeung, Bonnie and Bhaskaran, Krishnan and Gibbons, Cheryl L. and Katikireddi, Srinivasa Vittal and McCowan, Colin and Murray, Josie and O’Leary, Maureen and Ritchie, Lewis D. and Shah, Syed Ahmar and Simpson, Colin R. and Robertson, Chris and Sheikh, Aziz and Stock, Sarah J. and Wood, Rachael (2022) A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection. Nature Communications, 13 (1). 6124. ISSN 2041-1723 (https://doi.org/10.1038/s41467-022-33937-y)

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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.