Population-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. We describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. Between the start of a COVID-19 vaccine program in Scotland, on 8 December 2020 and 31 October 2021, 25,917 COVID-19 vaccinations were given to 18,457 pregnant women. Vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years; 32.3% of women giving birth in October 2021 had two doses of vaccine compared to 77.4% in all women. The extended perinatal mortality rate for women who gave birth within 28 d of a COVID-19 diagnosis was 22.6 per 1,000 births (95% CI 12.9−38.5; pandemic background rate 5.6 per 1,000 births; 452 out of 80,456; 95% CI 5.1−6.2). Overall, 77.4% (3,833 out of 4,950; 95% CI 76.2−78.6) of SARS-CoV-2 infections, 90.9% (748 out of 823; 95% CI 88.7−92.7) of SARS-CoV-2 associated with hospital admission and 98% (102 out of 104; 95% CI 92.5−99.7) of SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.

缺乏关于妊娠期 COVID-19 疫苗接种情况和 SARS-CoV-2 感染结果的人群数据。我们使用全国前瞻性队列的整体数据描述了苏格兰孕妇的 COVID-19 疫苗接种情况和 SARS-CoV-2 感染情况。自2020年12月8日至2021年10月31日苏格兰启动COVID-19疫苗计划期间，已为18,457名孕妇接种了25,917次COVID-19疫苗。孕妇的疫苗覆盖率明显低于 18-44 岁一般女性人群； 2021 年 10 月分娩的女性中有 32.3% 接种了两剂疫苗，而所有女性的这一比例为 77.4%。在诊断出 COVID-19 后 28 天内分娩的妇女的围产期死亡率为每 1,000 名新生儿 22.6 例（95% CI 12.9−38.5；大流行背景率为每 1,000 名新生儿 5.6 例；80,456 例中有 452 例；95% CI 5.1− 6.2）。总体而言，77.4%（4,950 例中的​​ 3,833 例；95% CI 76.2−78.6）的 SARS-CoV-2 感染、90.9%（823 例中的 748 例；95% CI 88.7−92.7）的 SARS-CoV-2 感染与入院相关98%（104 例中的 102 例；95% CI 92.5−99.7）与重症监护入院相关的 SARS-CoV-2 以及所有婴儿死亡均发生在诊断 COVID-19 时未接种疫苗的孕妇中。解决孕妇疫苗接种率低的问题对​​于在当前大流行中保护妇女和婴儿的健康至关重要。