To the Editor:

Pregnant women through coronavirus disease 2019 (Covid-19) are at boosted risk because that adverse outcomes, and also Covid-19 inoculation is recommended throughout pregnancy.1,2 However, security data on Covid-19 vaccination throughout pregnancy continue to be limited.3,4

We perform a case–control study with data indigenous Norwegian registries on first-trimester pregnancies, Covid-19 vaccination, elevator characteristics, and underlying health conditions (Supplementary Methods and also Tables S1 with S3 in the Supplementary Appendix, accessible with the complete text the this letter at We determined all women who were registered in between February 15 and August 15, 2021, as having had a miscarriage before 14 mainly of gestation (case patients) and those v a major care–based confirmation of continuous pregnancy in the first trimester (controls). In Norway, return vaccination during the an initial trimester is not recommended other than in women with underlying hazard conditions, women not yet mindful that they were pregnant may still it is in vaccinated in the an initial trimester. We approximated odds ratios through 95% confidence intervals because that Covid-19 inoculation within 5-week and also 3-week windows prior to a miscarriage or recurring pregnancy, adjusting for women’s age, nation of birth, marital status, educational level, family members income, variety of children, employment in a health care profession, basic risk conditions for Covid-19, vault test confident for significant acute respiratory syndrome coronavirus 2, and calendar month.

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Table 1.
Table 1. Odds Ratios because that Covid-19 inoculation in a 5-Week or 3-Week home window before heritage or check of an recurring Pregnancy.

Among 13,956 ladies with ongoing pregnancies (of who 5.5% to be vaccinated) and 4521 women with miscarriages (of who 5.1% to be vaccinated), the median variety of days in between vaccination and also miscarriage or confirmation of ongoing pregnancy was 19 (Fig. S2). Among women with miscarriages, the adjusted odds ratios for Covid-19 inoculation were 0.91 (95% confidence interval , 0.75 to 1.10) for vaccination in the vault 3 weeks and 0.81 (95% CI, 0.69 come 0.95) for vaccination in the ahead 5 weeks (Table 1). The outcomes were similar in an analysis that contained all available vaccine types (Table S5), in an evaluation stratified follow to the variety of doses got (one or two) (Table S6), and in sensitivity analyses limited to health treatment personnel (for whom inoculation was consistently recommended various other than in the an initial trimester) or women v at the very least 8 mainly of follow-up after shown pregnancy (to exclude subsequent pregnancy loss) (Table S7).

A limitation of our report is that the it is registered lacks information on gestational period at the moment of early on pregnancy registration, and thus we might not match instance patients and also controls according to gestational age. However, most known miscarriages are well-known to occur in between pregnancy mainly 6 and also 10,5 a period that is similar to the gestational eras at which women in Norway consult a physician to confirm pregnant (Fig. S1). Also, only approximately 40% of women in Norway have actually a primary treatment appointment to check pregnancy, however the features of this women appear to be similar to those of ladies who perform not have actually a registered pregnant confirmation (Table S4). We cannot deal with associations between vaccination and also miscarriages the were not clinically recognized. Back adjustment for potential confounders had actually minimal effect on ours results, the it is registered does not include information top top lifestyle and also other factors that can confound our result (see Supplementary Appendix).

Our study uncovered no proof of an increased risk for at an early stage pregnancy loss after Covid-19 vaccination and also adds come the result from other reports supporting Covid-19 vaccination during pregnancy.3,4

Maria C. Magnus, Ph.D.Håkon K. Gjessing, Ph.D.Helena N. Eide, M.D.Norwegian academy of windy Health, Oslo, Norway

Allen J. Wilcox, M.D., Ph.D.National academy of ecological Health Sciences, Durham, NC

Deshayne B. Fell, Ph.D.School the Epidemiology and Public Health, college of Ottawa, Ottawa, ON, Canada

Siri E. Håberg, M.D., Ph.D.Norwegian academy of public Health, Oslo, Norway

Supported in component by the study Council the Norway (project number, 324312) and through its Centers the Excellence resources scheme (project number, 262700) and also by NordForsk (project number, 105545). Dr. Magnus has received capital from the European study Council under the europe Union’s Horizon 2020 research and also innovation regimen (grant commitment number, 947684). The funders had no role in the completion of the study project, the composing of the manuscript because that publication, or the decision to submit the manuscript because that publication.

Disclosure forms provided by the authors are available with the complete text of this letter in ~

3. Zauche LH, Wallace B, Smoots AN, et al. Receipt that mRNA Covid-19 vaccines and risk of voluntary abortion. N Engl J Med 2021;385:1533-1535.

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4. Kharbanda EO, Haapala J, DeSilva M, et al. Voluntary abortion adhering to COVID-19 vaccination throughout pregnancy. JAMA 2021 September 8 (Epub front of print).

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5. Mukherjee S, Velez Edwards DR, Baird DD, Savitz DA, Hartmann KE. Hazard of miscarriage amongst black women and white females in a U.S. Prospective cohort study. Am J Epidemiol 2013;177:1271-1278.

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Vaccination Status5-Week Exposure Window3-Week Exposure WindowOngoing PregnanciesMiscarriagesUnadjusted Odds proportion (95% CI)Adjusted Odds ratio (95% CI)*Ongoing PregnanciesMiscarriagesUnadjusted Odds proportion (95% CI)Adjusted Odds ratio (95% CI)*numbernumber
Among every women
Vaccinated7722310.92 (0.79–1.07)0.81 (0.69–0.95)4491461.00 (0.83–1.21)0.91 (0.75–1.10)
Among health treatment personnel
Vaccinated261750.92 (0.70–1.20)0.93 (0.70–1.22)147430.94 (0.66–1.33)0.92 (0.64–1.32)