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Article ; Online: Delving Deeper Into Maternal COVID-19 Vaccination and Neonatal Outcomes-Reply.

Jorgensen, Sarah C J / Fell, Deshayne B / Kwong, Jeffrey C

2024 Volume 178, Issue 4, Page(s) 419–420

MeSH term(s)	Infant, Newborn ; Humans ; Pregnancy ; Female ; COVID-19/prevention & control ; COVID-19 Vaccines ; Vaccination ; Pregnancy Outcome
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2023.6683
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Article ; Online: Importance of considering infection during pregnancy: An underappreciated and preventable perinatal concern.

Regan, Annette K / Fell, Deshayne B

Paediatric and perinatal epidemiology

2022 Volume 36, Issue 4, Page(s) 447–449

MeSH term(s)	Female ; Humans ; Parturition ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/prevention & control
Language	English
Publishing date	2022-06-29
Publishing country	England
Document type	Editorial
ZDB-ID	639089-4
ISSN	1365-3016 ; 0269-5022 ; 1353-663X
ISSN (online)	1365-3016
ISSN	0269-5022 ; 1353-663X
DOI	10.1111/ppe.12909
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Article ; Online: SARS-CoV-2 infection in pregnancy: Lessons learned from the first pandemic wave.

Brandt, Justin S / Fell, Deshayne B

Paediatric and perinatal epidemiology

2021 Volume 35, Issue 1, Page(s) 34–36

MeSH term(s)	COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/therapy ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/therapy
Language	English
Publishing date	2021-02-26
Publishing country	England
Document type	Journal Article
ZDB-ID	639089-4
ISSN	1365-3016 ; 0269-5022 ; 1353-663X
ISSN (online)	1365-3016
ISSN	0269-5022 ; 1353-663X
DOI	10.1111/ppe.12745
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Article: Risk of Severe Maternal Morbidity Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection During Pregnancy.

Regan, Annette K / Arah, Onyebuchi A / Fell, Deshayne B / Sullivan, Sheena G

Open forum infectious diseases

2023 Volume 10, Issue 12, Page(s) ofad613

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy increases the risk of adverse fetal and neonatal outcomes, but the contribution to severe maternal morbidity (SMM) has been less frequently documented.!## ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy increases the risk of adverse fetal and neonatal outcomes, but the contribution to severe maternal morbidity (SMM) has been less frequently documented. Methods: We conducted a national cohort study of 93 624 deliveries occurring between 11 March 2020 and 1 July 2021 using medical claims information from the OptumLabs Data Warehouse. SARS-CoV-2 infection was identified from diagnostic and laboratory testing claims records. We identified 21 SMM conditions using Results: Approximately 5% of deliveries had a record of SARS-CoV-2 infection: 27.0% <7 days before delivery, 13.5% within 7-30 days of delivery, and 59.5% earlier in pregnancy. Compared to uninfected pregnancies, the adjusted risk of SMM was 2.22 times higher (95% confidence interval [CI], 1.97-2.48) among those infected <7 days before delivery and 1.66 times higher (95% CI, 1.23-2.08) among those infected 7-30 days before delivery. The highest risks were observed for acute respiratory distress syndrome (adjusted risk ratio [aRR], 13.24 [95% CI, 12.86-13.61]) and acute renal failure (aRR, 3.91 [95% CI, 3.32-4.50]). Conclusions: COVID-19 is associated with increased rates of SMM.
Language	English
Publishing date	2023-12-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad613
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Article ; Online: Analyzing Uncontrolled Confounding of the Perinatal Health Effects of Severe Acute Respiratory Syndrome Coronavirus 2 Infection During Pregnancy.

Arah, Onyebuchi A / Sullivan, Sheena G / Fell, Deshayne B / Regan, Annette K

The Journal of infectious diseases

2022 Volume 226, Issue 9, Page(s) 1678–1680

MeSH term(s)	Pregnancy ; Female ; Humans ; United States ; COVID-19 ; SARS-CoV-2 ; Pregnancy Complications, Infectious/virology ; Cohort Studies
Language	English
Publishing date	2022-05-09
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiac194
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Article ; Online: Impact of national recommendations for routine pertussis vaccination during pregnancy on infant pertussis in Ontario, Canada: a population-based time-series study.

Antoniou, Tony / McCormack, Daniel / Fell, Deshayne B / Kwong, Jeffrey C / Gomes, Tara

BMC pregnancy and childbirth

2023 Volume 23, Issue 1, Page(s) 627

Abstract: Background: In February 2018, Canada's National Advisory Committee on Immunization (NACI) recommended antenatal tetanus-diphtheria-acellular pertussis (Tdap) immunization in every pregnancy regardless of previous Tdap immunization history. We examined ... ...

Abstract	Background: In February 2018, Canada's National Advisory Committee on Immunization (NACI) recommended antenatal tetanus-diphtheria-acellular pertussis (Tdap) immunization in every pregnancy regardless of previous Tdap immunization history. We examined the impact of the NACI recommendation on rates of infant pertussis in Ontario, Canada. Methods: We conducted a population-based time-series study of all live births in Ontario between August 1, 2011 and February 28, 2020. We used interventional autoregressive integrated moving average models to examine the impact of the NACI recommendation on monthly rates of pertussis among infants ≤ 3 months of age. Results: We observed 675 incident cases of pertussis among 1,368,024 infants 3 months of age or less between August 2011 and February 2020. The average monthly percent change in infant pertussis during the period up to and including publication of the NACI guidance and the period following publication were 0.0% (95% CI: -0.4-0.3%) and - 0.8% (95% CI -2.3% to -0.1%), respectively. Following interventional ARIMA modelling, publication of the NACI guidance was not associated with a statistically significant decrease in the monthly pertussis incidence trend (-0.67 cases per 100,000 infants; p = 0.73). Conclusion: Publication of national recommendations for antenatal Tdap immunization in every pregnancy did not significantly reduce infant pertussis rates. This may reflect the persistently low rate of antenatal vaccination following publication of the recommendations. Expanding the scope of practice of allied health care providers to include antenatal Tdap immunization and patient education regarding antenatal pertussis immunization should be considered to further optimize uptake of vaccination.
MeSH term(s)	Pregnancy ; Infant ; Female ; Humans ; Ontario/epidemiology ; Whooping Cough/epidemiology ; Whooping Cough/prevention & control ; Vaccination ; Immunization ; Time Factors
Language	English
Publishing date	2023-08-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-023-05938-2
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Article ; Online: Comorbid conditions as risk factors for West Nile neuroinvasive disease in Ontario, Canada: a population-based cohort study.

Sutinen, Jessica / Fell, Deshayne B / Sander, Beate / Kulkarni, Manisha A

Epidemiology and infection

2022 Volume 150, Page(s) e103

Abstract: West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk ... ...

Abstract	West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk factors for WNND are still being explored. The objective of this study was to identify WNND comorbid risk factors in the Ontario population using a retrospective, population-based cohort design. Incident WNV infections from laboratory records between 1 January 2002 - 31 December 2012 were individually-linked to health administrative databases to ascertain WNND outcomes and comorbid risk factors. WNND incidence was compared among individuals with and without comorbidities using risk ratios (RR) calculated with log binomial regression.Three hundred and forty-five individuals developed WNND (18.3%) out of 1884 WNV infections. West Nile encephalitis was driving most associations with comorbidities. Immunocompromised (aRR 2.61 [95% CI 1.23-4.53]) and male sex (aRR 1.32 [95% CI 1.00-1.76]) were risk factors for encephalitis, in addition to age, for which each 1-year increase was associated with a 2% (aRR 1.02 [95% CI 1.02-1.03]) relative increase in risk. Our results suggest that individuals living with comorbidities are at higher risk for WNND, in particular encephalitis, following WNV infection.
MeSH term(s)	Cohort Studies ; Humans ; Male ; Ontario/epidemiology ; Retrospective Studies ; Risk Factors ; West Nile Fever/complications ; West Nile Fever/epidemiology ; West Nile virus
Language	English
Publishing date	2022-05-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632982-2
ISSN	1469-4409 ; 0950-2688
ISSN (online)	1469-4409
ISSN	0950-2688
DOI	10.1017/S0950268822000887
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Article ; Online: Miscarriage after SARS-CoV-2 vaccination: A population-based cohort study.

Velez, Maria P / Fell, Deshayne B / Shellenberger, Jonas P / Kwong, Jeffrey C / Ray, Joel G

BJOG : an international journal of obstetrics and gynaecology

2023 Volume 131, Issue 4, Page(s) 415–422

Abstract: Objective: To evaluate the risk of miscarriage following SARS-CoV-2 vaccination, while accounting for the competing risk of induced abortion.: Design: Population-based cohort study.: Setting: Ontario, Canada.: Participants: Women aged 15-50 ... ...

Abstract	Objective: To evaluate the risk of miscarriage following SARS-CoV-2 vaccination, while accounting for the competing risk of induced abortion. Design: Population-based cohort study. Setting: Ontario, Canada. Participants: Women aged 15-50 years with a confirmed pregnancy at ≤19 completed weeks' gestation. Methods: Exposure to first SARS-CoV-2 vaccination, handled in a time-varying manner, was defined as (i) unvaccinated, (ii) remotely vaccinated >28 days before the estimated conception date or (iii) recently vaccinated ≤28 days before conception and up to 120 days after conception. Main outcome measures: The outcome was miscarriage, occurring between the estimated date of conception and up to 19 completed weeks of pregnancy. Fine-Grey hazard models, accounting for the competing risk of induced abortion, generated hazard ratios (aHR), adjusted for socio-demographic factors, comorbidities, and biweekly periods. Results: Included were 246 259 pregnant women, of whom 34% received a first SARS-CoV-2 vaccination. Miscarriage occurred at a rate of 3.6 per 10 000 person-days among remotely vaccinated women and 3.2 per 10 000 person-days among those recently vaccinated, in contrast to a rate of 1.9 per 10 000 person-days among unvaccinated women, with corresponding aHR of 0.98 (95% confidence interval [CI] 0.91-1.07) and 1.00 (95% CI 0.93-1.08). Conclusions: SARS-CoV-2 vaccination was not associated with miscarriage while accounting for the competing risk of induced abortion. This study reiterates the importance of including pregnant women in new vaccine clinical trials and registries, and the rapid dissemination of vaccine safety data.
MeSH term(s)	Female ; Humans ; Pregnancy ; Abortion, Spontaneous/epidemiology ; Abortion, Spontaneous/etiology ; Cohort Studies ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Ontario/epidemiology ; SARS-CoV-2 ; Vaccination/adverse effects
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17721
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Article: Fresh Compared With Frozen Embryo Transfer and Risk of Severe Maternal Morbidity: A Study of In Vitro Fertilization Pregnancies in Ontario, Canada.

Smith, Julia / Fell, Deshayne B / Basso, Olga / Velez, Maria / Dayan, Natalie

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

2023 Volume 45, Issue 3, Page(s) 202–210

Abstract: Objectives: To quantify the risk of severe maternal morbidity (SMM) in fresh versus frozen-thawed embryo transfers (ETs) among pregnancies conceived by in vitro fertilization (IVF) and to assess SMM risk according to the number of fresh ETs prior to the ...

Abstract	Objectives: To quantify the risk of severe maternal morbidity (SMM) in fresh versus frozen-thawed embryo transfers (ETs) among pregnancies conceived by in vitro fertilization (IVF) and to assess SMM risk according to the number of fresh ETs prior to the index pregnancy. Methods: Retrospective cohort study using the provincial birth registry in Ontario, Canada. We included 13 929 individuals aged 18-55 years who conceived via IVF between January 1, 2013, and March 5, 2018, and delivered a live or stillborn infant ≥20 weeks gestation. We compared the primary outcome, a composite of SMM or death, between fresh and frozen ETs. Results: A total of 174 individuals who conceived via fresh ETs had SMM (30.7 per 1000), compared with 280 among individuals who received frozen ETs (33.9 per 1000); adjusted risk ratio (aRR) 0.85 (95% CI 0.70-1.04). Compared with frozen ET, fresh ET was associated with a lower risk of severe hemorrhage (aRR 0.63; 95% CI 0.48-0.82) but no difference in risk of preeclampsia. Among individuals with 1 (n = 211) or ≥2 (n = 88) prior fresh cycles, the risk of SMM was not increased compared with having no prior cycles; aRR 0.96 (95% CI 0.78-1.18) and 0.91 (95% CI 0.67-1.25), respectively. Conclusion: Fresh ET was associated with a lower risk of severe hemorrhage compared with frozen ET. These findings may be partly explained by the increased popularity of a freeze-all strategy, reserving fresh ETs for patients with fewer comorbidities.
MeSH term(s)	Female ; Pregnancy ; Humans ; Ontario/epidemiology ; Retrospective Studies ; Embryo Transfer ; Fertilization in Vitro/adverse effects ; Hemorrhage ; Cryopreservation
Language	English
Publishing date	2023-01-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2171082-X
ISSN	1701-2163
ISSN	1701-2163
DOI	10.1016/j.jogc.2023.01.001
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Article ; Online: Estimated Effectiveness of Postpartum Maternal Messenger RNA COVID-19 Vaccination Against Delta and Omicron SARS-CoV-2 Infection and Hospitalization in Infants Younger Than 6 Months.

Jorgensen, Sarah C J / Hernandez, Alejandro / Fell, Deshayne B / Austin, Peter C / D'Souza, Rohan / Guttmann, Astrid / Kwong, Jeffrey C

JAMA pediatrics

2023 Volume 177, Issue 4, Page(s) 427–430

MeSH term(s)	Female ; Humans ; Infant ; COVID-19/prevention & control ; COVID-19 Vaccines ; RNA, Messenger, Stored ; SARS-CoV-2/genetics ; Hospitalization ; Vaccination
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger, Stored
Language	English
Publishing date	2023-03-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2022.6134
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