Adherence to infection prevention measures and vaccine uptake among pregnant women and new mothers in Sweden during the COVID-19 pandemic

The COVID-19 pandemic was a global public health crisis that affected everyone, including pregnant women and new mothers. Previous research suggests this population adhered well to infection prevention measures, though vaccine uptake was limited due to safety concerns. Sweden’s largely voluntary and less restrictive pandemic response provided a unique context to study adherence and vaccination patterns. This study aimed to examine adherence to infection prevention measures and COVID-19 vaccination among pregnant women, new mothers, and their families. We conducted a longitudinal study using data from the prospective population-based NorthPop Birth Cohort Study in Sweden. Repeated questionnaires were distributed between June 2020 and December 2021, enabling assessment of self-reported adherence to infection prevention measures and COVID-19 vaccination uptake. Descriptive statistics were applied, and differences were analysed using Pearson’s chi-square test and independent-samples t-tests. Sensitivity analyses were performed to examine differences in adherence between participants who were pregnant during the pandemic and postpartum participants, and associations with vaccination were examined using univariable logistic regression. Pregnant women and new mothers reported high adherence to infection prevention measures, peaking in December 2020 and declining thereafter for most behaviours. Compared with postpartum participants, women who were pregnant during the pandemic were less likely to limit social contacts (OR = 0.69, 95% CI: 0.49–0.97) and to stay home when experiencing cold symptoms (OR = 0.68, 95% CI: 0.49–0.93). Vaccine uptake was high (94.7%) among all participants. Participants with at least a university degree were more likely to be vaccinated than those with lower educational level (OR = 3.04, 95% CI: 1.87–4.92), and the likelihood of vaccination increased by 9% with each additional year of age (OR = 1.09, 95% CI: 1.03–1.15). Trust in public authorities and the healthcare system, together with a strong sense of collective responsibility, may partly explain the high adherence to recommendations and COVID-19 vaccine uptake among pregnant women and new mothers during the COVID-19 pandemic in Sweden. Sociodemographic differences in vaccine uptake highlight the need for targeted communication and support. These findings provide insights relevant for future pandemic preparedness and maternal health policy across Europe.