Neonatal deaths, Covid vaccines, and what caused the spike? – HeraldScotland

A second spike in March 2022, coupled with consistently higher than average rates over an eight month period from March to October 2021, reinforced suspicion.

The logic was simple: this was something that had not been seen before, and it had coincided with a period when something else was new - that is, expectant mothers being vaccinated against Covid.

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Anxiety had already been fostered by mixed messages over its safety, with pregnant women initially advised against vaccination early in the rollout due to a lack of clinical trial data (expectant mothers were, understandably, not recruited onto vaccine studies).

By the time official guidance was updated in April 2021, on the basis of mounting real-world evidence for its safety, mothers found themselves coming up against contradictory statements from healthcare professionals (some reported their midwives urging them not to be "guinea pigs") and social media was quickly awash with fake news and misinformation.

Uptake rates among expectant mothers lagged far behind those of women in the same age group, sometimes with tragic consequences as the increased risk of Covid complications in pregnancy became clear.

Today's report covers 135 neonatal deaths in Scotland from April 2021 to March 2022, of which 30 are considered to have been "excess" - in other words, above what would be normal based on previous years' trends.

However, as it makes clear, the review has "intentionally" avoided any specific analyses into Covid links because this sample size is "too small to make such comparisons statistically valid".

The same would be true of vaccination status, but - as the review notes - "maternal Covid vaccination status was not detailed in any of the local reviews analysed".

The question mark will linger on then - unhelpfully, and unfairly.

Maternal vaccination status was not recorded, but large-scale population studies show it is safe during pregnancy (Image: Getty)

In Scottish terms, the most meaningful evidence in relation to Covid and vaccination in pregnancy comes fromEdinburgh University's COPS database, which has tracked more than 81,000 pregnancies including 12,800 in which the mothers were vaccinated.

It found that a baby was 35% more likely to be born pre-term if a mother had Covid, but there was "no evidence of increased risk of any adverse maternal or neonatal outcome following vaccination either shortly before or during pregnancy".

This is consistent with other studies worldwide.

A higher than expected number of babies were born before 28 weeks and there was also a "significant increase" in deaths among those bornpre-term at 32-36 weeks, but what role - if any - was played by Covid infections during pregnancy remains unclear.

The review noted that Covid was mentioned in relation to only seven of the cases it examined, forstaff absences, one case of long Covid, and four mothers who tested positive around the time of delivery.

The registered causes of neonatal deaths during 2021/22 "were broadly similar to those in previous years, with no new or unusual causes of death identified".

While there is possible evidence of "higher rate of labour and delivery problems" - in some cases including delays to performing caesarean sections, or an undiagnosed breech birth - this "does not explain in full the increase in neonatal mortality" during the year, and no "systemic" problems with maternity or neonatal care were found.

More worrying - particularly for parents who have experienced baby loss - is that local reviews into the deaths, carried out by health boards, are described as "poor quality, inconsistent and incomplete".

This, rather than vaccine misinformation, should be the key takeaway, because it means we are missing opportunities to learn lessons and prevent avoidable tragedies being repeated.

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Neonatal deaths, Covid vaccines, and what caused the spike? - HeraldScotland