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

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.

Author list



  1. Usher Institute, University of Edinburgh, Edinburgh, UK. 
  2. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 
  3. Public Health Scotland, Scotland, UK. 
  4. Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 
  5. Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK. 
  6. Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK. 
  7. MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK. 
  8. School of Medicine, University of St Andrews, St Andrews, UK. 
  9. Academic Primary Care, University of Aberdeen, Aberdeen, UK. 
  10. School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand. 


Clara Calvert, Jade Carruthers, Cheryl Denny, Jack Donaghy, Sam Hillman, Lisa E. M. Hopcroft, Leanne Hopkins, Anna Goulding, Laura Lindsay, Terry McLaughlin, Emily Moore, Jiafeng Pan, Bob Taylor, Fatima Almaghrabi, Bonnie Auyeung, Krishnan Bhaskaran, Cheryl L. Gibbons, Srinivasa Vittal Katikireddi, Colin McCowan, Josie Murray, Maureen O’Leary, Lewis D. Ritchie, Syed Ahmar Shah, Colin R. Simpson, Chris Robertson, Aziz Sheikh, Sarah J. Stock & Rachael Wood 

Novel Coronavirus SARS-CoV-2


Nature - Communications