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Risk of preterm birth, small for gestational age at birth, and stillbirth after covid-19 vaccination during pregnancy: population based retrospective cohort study.
Fell, Deshayne B; Dimanlig-Cruz, Sheryll; Regan, Annette K; Håberg, Siri E; Gravel, Christopher A; Oakley, Laura; Alton, Gillian D; Török, Eszter; Dhinsa, Tavleen; Shah, Prakesh S; Wilson, Kumanan; Sprague, Ann E; El-Chaâr, Darine; Walker, Mark C; Barrett, Jon; Okun, Nannette; Buchan, Sarah A; Kwong, Jeffrey C; Wilson, Sarah E; Dunn, Sandra I; MacDonald, Shannon E; Dougan, Shelley D.
  • Fell DB; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada dfell@cheo.on.ca.
  • Dimanlig-Cruz S; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
  • Regan AK; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
  • Håberg SE; Better Outcomes Registry and Network (BORN) Ontario, Ottawa, ON, Canada.
  • Gravel CA; School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
  • Oakley L; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
  • Alton GD; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
  • Török E; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
  • Dhinsa T; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
  • Shah PS; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
  • Wilson K; Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  • Sprague AE; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.
  • El-Chaâr D; Better Outcomes Registry and Network (BORN) Ontario, Ottawa, ON, Canada.
  • Walker MC; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.
  • Barrett J; Better Outcomes Registry and Network (BORN) Ontario, Ottawa, ON, Canada.
  • Okun N; Better Outcomes Registry and Network (BORN) Ontario, Ottawa, ON, Canada.
  • Buchan SA; Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada.
  • Kwong JC; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
  • Wilson SE; Maternal-infant Care Research Centre, Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada.
  • Dunn SI; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
  • MacDonald SE; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
  • Dougan SD; Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
BMJ ; 378: e071416, 2022 08 17.
Article in English | MEDLINE | ID: covidwho-1992992
ABSTRACT

OBJECTIVE:

To assess the risk of preterm birth, small for gestational age at birth, and stillbirth after covid-19 vaccination during pregnancy.

DESIGN:

Population based retrospective cohort study.

SETTING:

Ontario, Canada, 1 May to 31 December 2021.

PARTICIPANTS:

All liveborn and stillborn infants from pregnancies conceived at least 42 weeks before the end of the study period and with gestational age ≥20 weeks or birth weight ≥500 g. MAIN OUTCOME

MEASURES:

Using Cox regression, hazard ratios and 95% confidence intervals were estimated for preterm birth before 37 weeks (overall and spontaneous preterm birth), very preterm birth (<32 weeks), small for gestational age at birth (<10th centile), and stillbirth. Vaccination against covid-19 was treated as a time varying exposure in the outcome specific risk window, and propensity score weighting was used to adjust hazard ratios for potential confounding.

RESULTS:

Among 85 162 births, 43 099 (50.6%) occurred in individuals who received one dose or more of a covid-19 vaccine during pregnancy-42 979 (99.7%) received an mRNA vaccine. Vaccination during pregnancy was not associated with any increased risk of overall preterm birth (6.5% among vaccinated v 6.9% among unvaccinated; adjusted hazard ratio 1.02, 95% confidence interval 0.96 to 1.08), spontaneous preterm birth (3.7% v 4.4%; 0.96, 0.90 to 1.03), or very preterm birth (0.59% v 0.89%; 0.80, 0.67 to 0.95). No increase was found in risk of small for gestational age at birth (9.1% v 9.2%; 0.98, 0.93 to 1.03) or stillbirth (0.25% v 0.44%; 0.65, 0.51 to 0.84). Findings were similar by trimester of vaccination, mRNA vaccine product, and number of doses received during pregnancy.

CONCLUSION:

The findings suggest that vaccination against covid-19 during pregnancy is not associated with a higher risk of preterm birth, small for gestational age at birth, or stillbirth.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Premature Birth / Stillbirth / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: BMJ Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Bmj-2022-071416

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Premature Birth / Stillbirth / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant / Infant, Newborn / Pregnancy Country/Region as subject: North America Language: English Journal: BMJ Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Bmj-2022-071416