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Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study

OBJECTIVE: To assess risk of adverse pregnancy, fetal, and neonatal outcomes after a third dose (first booster dose) of covid-19 vaccine during pregnancy among individuals who had completed both doses of primary covid-19 vaccine series before pregnancy. DESIGN: Population based, retrospective cohort...

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Autores principales: Fell, Deshayne B, Dimanlig-Cruz, Sheryll, Török, Eszter, Håberg, Siri E, Regan, Annette K, Kaufman, Jay S, Platt, Robert W, Gravel, Christopher A, Bruce, Liam, Shah, Prakesh S, Wilson, Kumanan, Sprague, Ann E, Alton, Gillian D, Dhinsa, Tavleen, El-Chaâr, Darine, Buchan, Sarah A, Kwong, Jeffrey C, Wilson, Sarah E, Dunn, Sandra I, MacDonald, Shannon E, Barrett, Jon, Okun, Nannette, Walker, Mark C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347452/
https://www.ncbi.nlm.nih.gov/pubmed/37456362
http://dx.doi.org/10.1136/bmjmed-2023-000632
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author Fell, Deshayne B
Dimanlig-Cruz, Sheryll
Török, Eszter
Håberg, Siri E
Regan, Annette K
Kaufman, Jay S
Platt, Robert W
Gravel, Christopher A
Bruce, Liam
Shah, Prakesh S
Wilson, Kumanan
Sprague, Ann E
Alton, Gillian D
Dhinsa, Tavleen
El-Chaâr, Darine
Buchan, Sarah A
Kwong, Jeffrey C
Wilson, Sarah E
Dunn, Sandra I
MacDonald, Shannon E
Barrett, Jon
Okun, Nannette
Walker, Mark C
author_facet Fell, Deshayne B
Dimanlig-Cruz, Sheryll
Török, Eszter
Håberg, Siri E
Regan, Annette K
Kaufman, Jay S
Platt, Robert W
Gravel, Christopher A
Bruce, Liam
Shah, Prakesh S
Wilson, Kumanan
Sprague, Ann E
Alton, Gillian D
Dhinsa, Tavleen
El-Chaâr, Darine
Buchan, Sarah A
Kwong, Jeffrey C
Wilson, Sarah E
Dunn, Sandra I
MacDonald, Shannon E
Barrett, Jon
Okun, Nannette
Walker, Mark C
author_sort Fell, Deshayne B
collection PubMed
description OBJECTIVE: To assess risk of adverse pregnancy, fetal, and neonatal outcomes after a third dose (first booster dose) of covid-19 vaccine during pregnancy among individuals who had completed both doses of primary covid-19 vaccine series before pregnancy. DESIGN: Population based, retrospective cohort study. SETTING: Ontario, Canada, from 20 December 2021 to 31 August 2022. PARTICIPANTS: Individuals were included if they were pregnant with an expected date of delivery from 20 December 2021 (start date of third dose eligibility for everyone ≥18 years) to 31 August 2022, who had completed the two doses of primary covid-19 messenger RNA vaccine series before pregnancy, and became eligible for a third dose (≥six months since dose two) before the end of pregnancy. MAIN OUTCOME MEASURES: Pregnancy outcomes included hypertensive disorders of pregnancy, placental abruption, caesarean delivery, chorioamnionitis, and postpartum hemorrhage. Fetal and neonatal outcomes included stillbirth, preterm birth, admission to neonatal intensive care unit for >24 h, newborn 5 min Apgar score <7, and small-for-gestational age infant (<10th percentile). We estimated hazard ratios and 95% confidence intervals for study outcomes, treating dose three as a time varying exposure and adjusting for confounding using inverse probability weighting. RESULTS: Among 32 689 births, 18 491 (56.6%) were born to individuals who received a third covid-19 dose during pregnancy. Compared with eligible individuals who did not receive a third dose during pregnancy, no increased risks were associated with receiving a third covid-19 vaccine dose during pregnancy for placental abruption (adjusted hazard ratio 0.84 (95% confidence interval 0.70 to 1.02)), chorioamnionitis (0.67 (0.49 to 0.90)), postpartum haemorrhage (1.01 (0.89 to 1.16)), caesarean delivery (0.90 (0.87 to 0.94)), stillbirth (0.56 (0.39 to 0.81)), preterm birth (0.91 (0.84 to 0.99)), neonatal intensive care unit admission (0.96 (0.90 to 1.03)), 5 min Apgar score<7 (0.96 (0.82 to 1.14)), or small-for-gestational age infant (0.86 (0.79 to 0.93)). CONCLUSION: Receipt of a third covid-19 vaccine dose during pregnancy was not associated with an increased risk of adverse pregnancy, fetal, or neonatal outcomes. These findings can help to inform evidence based decision making about the risks and benefits of covid-19 booster doses during pregnancy.
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spelling pubmed-103474522023-07-15 Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study Fell, Deshayne B Dimanlig-Cruz, Sheryll Török, Eszter Håberg, Siri E Regan, Annette K Kaufman, Jay S Platt, Robert W Gravel, Christopher A Bruce, Liam Shah, Prakesh S Wilson, Kumanan Sprague, Ann E Alton, Gillian D Dhinsa, Tavleen El-Chaâr, Darine Buchan, Sarah A Kwong, Jeffrey C Wilson, Sarah E Dunn, Sandra I MacDonald, Shannon E Barrett, Jon Okun, Nannette Walker, Mark C BMJ Med Original Research OBJECTIVE: To assess risk of adverse pregnancy, fetal, and neonatal outcomes after a third dose (first booster dose) of covid-19 vaccine during pregnancy among individuals who had completed both doses of primary covid-19 vaccine series before pregnancy. DESIGN: Population based, retrospective cohort study. SETTING: Ontario, Canada, from 20 December 2021 to 31 August 2022. PARTICIPANTS: Individuals were included if they were pregnant with an expected date of delivery from 20 December 2021 (start date of third dose eligibility for everyone ≥18 years) to 31 August 2022, who had completed the two doses of primary covid-19 messenger RNA vaccine series before pregnancy, and became eligible for a third dose (≥six months since dose two) before the end of pregnancy. MAIN OUTCOME MEASURES: Pregnancy outcomes included hypertensive disorders of pregnancy, placental abruption, caesarean delivery, chorioamnionitis, and postpartum hemorrhage. Fetal and neonatal outcomes included stillbirth, preterm birth, admission to neonatal intensive care unit for >24 h, newborn 5 min Apgar score <7, and small-for-gestational age infant (<10th percentile). We estimated hazard ratios and 95% confidence intervals for study outcomes, treating dose three as a time varying exposure and adjusting for confounding using inverse probability weighting. RESULTS: Among 32 689 births, 18 491 (56.6%) were born to individuals who received a third covid-19 dose during pregnancy. Compared with eligible individuals who did not receive a third dose during pregnancy, no increased risks were associated with receiving a third covid-19 vaccine dose during pregnancy for placental abruption (adjusted hazard ratio 0.84 (95% confidence interval 0.70 to 1.02)), chorioamnionitis (0.67 (0.49 to 0.90)), postpartum haemorrhage (1.01 (0.89 to 1.16)), caesarean delivery (0.90 (0.87 to 0.94)), stillbirth (0.56 (0.39 to 0.81)), preterm birth (0.91 (0.84 to 0.99)), neonatal intensive care unit admission (0.96 (0.90 to 1.03)), 5 min Apgar score<7 (0.96 (0.82 to 1.14)), or small-for-gestational age infant (0.86 (0.79 to 0.93)). CONCLUSION: Receipt of a third covid-19 vaccine dose during pregnancy was not associated with an increased risk of adverse pregnancy, fetal, or neonatal outcomes. These findings can help to inform evidence based decision making about the risks and benefits of covid-19 booster doses during pregnancy. BMJ Publishing Group 2023-07-11 /pmc/articles/PMC10347452/ /pubmed/37456362 http://dx.doi.org/10.1136/bmjmed-2023-000632 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Fell, Deshayne B
Dimanlig-Cruz, Sheryll
Török, Eszter
Håberg, Siri E
Regan, Annette K
Kaufman, Jay S
Platt, Robert W
Gravel, Christopher A
Bruce, Liam
Shah, Prakesh S
Wilson, Kumanan
Sprague, Ann E
Alton, Gillian D
Dhinsa, Tavleen
El-Chaâr, Darine
Buchan, Sarah A
Kwong, Jeffrey C
Wilson, Sarah E
Dunn, Sandra I
MacDonald, Shannon E
Barrett, Jon
Okun, Nannette
Walker, Mark C
Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title_full Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title_fullStr Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title_full_unstemmed Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title_short Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study
title_sort pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in ontario, canada: population based, retrospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347452/
https://www.ncbi.nlm.nih.gov/pubmed/37456362
http://dx.doi.org/10.1136/bmjmed-2023-000632
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