When the COVID-19 pandemic was declared in March 2020, BORN quickly realized that if the SARS-COV2 virus was like past respiratory virus pandemics, pregnant individuals and newborns could be adversely affected. Consistent with our mandate to facilitate and improve care, we knew that health policy makers, funders, pregnant individuals and their health-care providers would need good information to make decisions.
With Ontario’s large numbers of births/year, we knew we could add important information to the scientific literature. We worked rapidly with hospital and midwifery clinic data providers and provincial and national research groups to develop data collection systems and data linkages to COVID-19 testing and the COVID-19 vaccination registries.
We have published a number of reports and manuscripts and have worked closely with the Canadian COVID-19 pregnancy group (CAN-COVID preg) to show patterns of illness and outcomes, vaccination usage and outcomes, and socio-demographic factors associated with both.
Fell DB, Dimanlig-Cruz S, Török E, Håberg SE, Regan AK, Kaufman JS, Platt RW, Gravel CA, Bruce L, Shah PS, Wilson K, Sprague AE, Alton GD, Dhinsa T, El-Chaâr D, Buchan SA, Kwong JC, Wilson SE, Dunn SI, MacDonald SE, Barrett J, Okun N, Walker MC. Pregnancy, fetal, and neonatal outcomes after a first booster dose of covid-19 vaccine during pregnancy in Ontario, Canada: population based, retrospective cohort study. BMJ Med. 2023 Jul 11;2(1):e000632. doi: 10.1136/bmjmed-2023-000632. PMID: 37456362; PMCID: PMC10347452.
Fell DB, Török E, Sprague AE, Regan AK, Dhinsa T, Alton GD, Dimanlig-Cruz S, MacDonald SE, Buchan SA, Kwong JC, Wilson SE, Håberg SE, Gravel CA, Wilson K, Dunn SI, Shah PS, El-Chaâr D, Barrett J, Walker MC, Okun N, Dougan SD. Temporal trends and determinants of COVID-19 vaccine coverage and series initiation during pregnancy in Ontario, Canada, December 2020 to December 2021: A population-based retrospective cohort study. Vaccine. 2023 Mar 3;41(10):1716-1725. doi: 10.1016/j.vaccine.2023.01.073. Epub 2023 Feb 3. PMID: 36759282; PMCID: PMC9894778.
This paper examines coverage estimates for COVID-19 vaccination before and during pregnancy in Ontario. We found that COVID-19 vaccine coverage among pregnant individuals remained lower than in the general population, and there was lower vaccine initiation by multiple characteristics.
Roberts NF, Sprague AE, Taljaard M, Fell DB, Ray JG, Tunde-Byass M, Biringer A, Barrett JFR, Khurshid F, Diaz S, Bellai-Dussault K, Radke DM, Bisnaire LM, Armour CM, Joiner IC, Walker MC. Maternal-Newborn Health System Changes and Outcomes in Ontario, Canada, During Wave 1 of the COVID-19 Pandemic-A Retrospective Study. J Obstet Gynaecol Can. 2022 Jun;44(6):664-674. doi: 10.1016/j.jogc.2021.12.006. Epub 2021 Dec 29. PMID: 34973435; PMCID: PMC8716144.
This paper looked at the population impact of Wave 1 of the COVID-19 pandemic on obstetric practices and the pregnancy and birth outcomes in Ontario. Key findings were that provincial health system changes implemented early in the pandemic did not result in significant increases in adverse outcomes.
Fell DB, Dimanlig-Cruz S, Regan AK, Håberg SE, Gravel CA, Oakley L, Alton GD, Török E, Dhinsa T, Shah PS, Wilson K, Sprague AE, El-Chaâr D, Walker MC, Barrett J, Okun N, Buchan SA, Kwong JC, Wilson SE, Dunn SI, MacDonald SE, Dougan SD. Risk of preterm birth, small for gestational age at birth, and stillbirth after covid-19 vaccination during pregnancy: population based retrospective cohort study. BMJ. 2022 Aug 17;378:e071416. doi: 10.1136/bmj-2022-071416. PMID: 35977737; PMCID: PMC9382031.
This paper assessed the risk of preterm birth, SGA and stillbirth after COVID-19 vaccination in pregnancy and found no association or higher risk of any of these outcomes.
McClymont E, Albert AY, Alton GD, Boucoiran I, Castillo E, Fell DB, Kuret V, Poliquin V, Reeve T, Scott H, Sprague AE, Carson G, Cassell K, Crane J, Elwood C, Joynt C, Murphy P, Murphy-Kaulbeck L, Saunders S, Shah P, Snelgrove JW, van Schalkwyk J, Yudin MH, Money D; CANCOVID-Preg Team. Association of SARS-CoV-2 Infection During Pregnancy With Maternal and Perinatal Outcomes. JAMA. 2022 May 24;327(20):1983-1991. doi: 10.1001/jama.2022.5906. PMID: 35499852; PMCID: PMC9062768.
This paper explored whether Is SARS-CoV-2 infection during pregnancy was associated with increased risk of adverse maternal and perinatal outcomes. This pan-Canadian study found that among over 6000 cases of COVID-19 infection in pregnant individuals there was increased risk of SARS-CoV-2–related hospitalization (relative risk, 2.65) and intensive care unit admission (relative risk, 5.46). Among cases of infection during pregnancy compared with pregnant individuals without SARS-CoV-2 infection, there was a significantly increased risk of preterm birth (relative risk, 1.63).
Fell DB, Dhinsa T, Alton GD, Török E, Dimanlig-Cruz S, Regan AK, Sprague AE, Buchan SA, Kwong JC, Wilson SE, Håberg SE, Gravel CA, Wilson K, El-Chaâr D, Walker MC, Barrett J, MacDonald SE, Okun N, Shah PS, Dougan SD, Dunn S, Bisnaire L. Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes. JAMA. 2022 Apr 19;327(15):1478-1487. doi: 10.1001/jama.2022.4255. PMID: 35323842; PMCID: PMC8949767.
Looking at almost 100,000 pregnant individuals we found no significant association with an increased risk of adverse peripartum outcomes associated with the COVID-19 vaccination in pregnancy.
