Pregnancy during COVID-19: social contact patterns and vaccine coverage of pregnant women from CoMix in 19 European countries

  1. Kerry L. M. Wong
  2. Amy Gimma
  3. Enny S. Paixao
  4. CoMix Europe Working Group
  5. Daniela Paolotti
  6. André Karch
  7. Veronika Jäger
  8. Joaquin Baruch
  9. Tanya Melillo
  10. Henrieta Hudeckova
  11. Magdalena Rosinska
  12. Marta Niedzwiedzka-Stadnik
  13. Krista Fischer
  14. Sigrid Vorobjov
  15. Hanna Sõnajalg
  16. Christian Althaus
  17. Nicola Low
  18. Martina Reichmuth
  19. Kari Auranen
  20. Markku Nurhonen
  21. Goranka Petrović
  22. Zvjezdana Lovric Makaric
  23. Sónia Namorado
  24. Constantino Caetano
  25. Ana João Santos
  26. Gergely Röst
  27. Beatrix Oroszi
  28. Márton Karsai
  29. Mario Fafangel
  30. Petra Klepac
  31. Natalija Kranjec
  32. Cristina Vilaplana
  33. Jordi Casabona
  34. Christel Faes
  35. Philippe Beutels
  36. Niel Hens
  37. Christopher I. Jarvis
  38. W. John Edmunds

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Abstract

Background

Evidence and advice for pregnant women evolved during the COVID-19 pandemic. We studied social contact behaviour and vaccine uptake in pregnant women between March 2020 and September 2021 in 19 European countries.

Methods

In each country, repeated online survey data were collected from a panel of nationally-representative participants. We calculated the adjusted mean number of contacts reported with an individual-level generalized additive mixed model, modelled using the negative binomial distribution and a log link function. Mean proportion of people in isolation or quarantine, and vaccination coverage by pregnancy status and gender were calculated using a clustered bootstrap.

Findings

We recorded 4,129 observations from 1,041 pregnant women, and 115,359 observations from 29,860 non-pregnant individuals aged 18–49. Pregnant women made slightly fewer contacts (3.6, 95%CI = 3.5–3.7) than non-pregnant women (4.0, 95%CI = 3.9–4.0), driven by fewer work contacts but marginally more contacts in non-essential social settings. Approximately 15–20% pregnant and 5% of non-pregnant individuals reported to be in isolation and quarantine for large parts of the study period.

COVID-19 vaccine coverage was higher in pregnant women than in non-pregnant women between January and April 2021. Since May 2021, vaccination in non-pregnant women began to increase and surpassed that in pregnant women.

Interpretation

Limited social contact to avoid pathogen exposure during the COVID-19 pandemic has been a challenge to many, especially women going through pregnancy. More recognition of maternal social support desire is needed in the ongoing pandemic. As COVID-19 vaccination continues to remain an important pillar of outbreak response, strategies to promote correct information can provide reassurance and facilitate informed pregnancy vaccine decisions in this vulnerable group.

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  1. Version published to 10.1186/s12884-022-05076-1
  2. Version published to 10.1101/2022.06.01.22275775v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2022.06.01.22275775: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: In the UK, the study was approved by the ethics committee of the London School of Hygiene and Tropical Medicine (Reference number: 21795).
    Sex as a biological variableStudy participants: In this analysis, we included pregnant women (self-identified) aged 18-49 years, and non-pregnant women and men of the same age who reported to have no risk factors for serious symptoms if they contracted COVID-19.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The findings presented in this study should be interpreted with several limitations in mind. First, more than half of our data came from the UK which may have obscured patterns from other countries. Relatedly, for the analysis of COVID-19 vaccination in countries other than the UK, we grouped 18 countries together due to data availability. This approach neglected variations in vaccination schedules and the evolution of vaccine policies on pregnancy in individual countries. Both risk perceptions to COVID-19 and vaccine hesitancy also likely differ across countries and change over time. Future research is highly warranted as more data become available. Second, we did not collect data on gravidity and gestational age from pregnant women, which likely have important relationships with perceived need of social support and vaccine acceptance. Future studies should explore factors associated with subgroups of pregnant women requiring particular attention. Third, pregnant and non-pregnant individuals may have interpreted the questions on isolation and quarantine due to COVID-19 differently. Terminologies such as “isolation”, “quarantine” and “social distancing” are distinctively different yet somewhat similar notions that might be misinterpreted, especially for high-risk people who have been given stricter guidelines to maintain social distancing as a form of preventive measure. Our finding on isolation and quarantine might have over-estimated the proportion of pregnant women who wer...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  4. Version published to 10.1101/2022.06.01.22275775v1 on medRxiv