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Did smallpox cause stillbirths? Maternal smallpox infection, vaccination, and stillbirths in Sweden, 1780–1839

Eric Schneider, Sören Edvinsson and Kota Ogasawara

Population Studies, 2024, vol. 78, issue 3, 467-482

Abstract: While there is strong evidence that maternal smallpox infection can cause foetal loss, it is not clear whether smallpox infections were a demographically important cause of stillbirths historically. In this paper, we use parish-level data from the Swedish Tabellverket data set for 1780–1839 to test the effect of smallpox on stillbirths quantitatively, analysing periods before and after the introduction of vaccination in 1802. We find that smallpox infection was not a major cause of stillbirths before 1820, because most women contracted smallpox as children and were therefore not susceptible during pregnancy. We do find a small, statistically significant effect of smallpox on stillbirths from 1820 to 1839, when waning immunity from vaccination put a greater share of pregnant women at risk of contracting smallpox. However, the reduced prevalence of smallpox in this period limited its impact on stillbirths. Thus, smallpox was not an important driver of historical stillbirth trends.

Date: 2024
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Working Paper: Did smallpox cause stillbirths? Maternal smallpox infection, vaccination and stillbirths in Sweden, 1780-1839 (2023) Downloads
Working Paper: Did Smallpox Cause Stillbirths? Maternal Smallpox Infection, Vaccination and Stillbirths in Sweden, 1780-1839 (2022) Downloads
Working Paper: Did smallpox cause stillbirths? Maternal smallpox infection, vaccination and stillbirths in Sweden, 1780-1839 (2022) Downloads
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DOI: 10.1080/00324728.2023.2174266

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Population Studies is currently edited by John Simons, Francesco Billari, James J. Brown, John Cleland, Andrew Foster, John McDonald, Tom Moultrie, Mikko Myrsklä, Alice Reid, Wendy Sigle-Rushton, Ronald Skeldon and Frans Willekens

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