Maternal vaccination against COVID-19 and neonatal outcomes during Omicron: INTERCOVID-2022 study

American Journal of Obstetrics and Gynecology, Journal Year: 2024, Volume and Issue: 231(4), P. 460.e1 - 460.e17

Published: Feb. 16, 2024

Language: Английский

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Pathogenesis of viral infections during pregnancy

Clinical Microbiology Reviews, Journal Year: 2024, Volume and Issue: 37(2)

Published: Feb. 29, 2024

SUMMARY Viral infections during pregnancy are associated with significant adverse perinatal and fetal outcomes. Pregnancy is a unique immunologic physiologic state, which can influence control of virus replication, severity disease, vertical transmission. The placenta the organ maternal-fetal interface provides defense against microbial infection while supporting semi-allogeneic fetus via tolerogenic immune responses. Some viruses, such as cytomegalovirus, Zika virus, rubella breach these defenses, directly infecting having long-lasting consequences. Even without direct placental infection, other including respiratory viruses like influenza severe acute syndrome coronavirus 2, still cause damage inflammation. Concentrations progesterone estrogens rise contribute to immunological adaptations, placentation, development play pivotal role in creating environment at interface. Animal models, mice, nonhuman primates, rabbits, guinea pigs, instrumental for mechanistic insights into pathogenesis viral identification targetable treatments improve health outcomes pregnant individuals offspring.

Language: Английский

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Uptake of Recommended Vaccines During Pregnancy Among Publicly and Privately Insured People in the United States, December 2020–September 2022

American Journal of Public Health, Journal Year: 2025, Volume and Issue: unknown, P. e1 - e10

Published: Jan. 23, 2025

Objectives. To estimate maternal COVID-19, influenza, and pertussis vaccine uptake during pregnancy by insurance type identify factors characterizing those vaccinated unvaccinated. Methods. We conducted a US cohort study of pregnant individuals (for pregnancies ending December 11, 2020–September 30, 2022) using claims data. calculated vaccination probability Kaplan-Meier methods identified associated with through binomial regression inverse weights. Results. Among 695 887 (median age = 32 years for privately 27 publicly insured), the cumulative COVID-19 was 43.0% (privately insured) 11.8% (publicly insured). observed marked disparities between influenza (33.2% vs 14.2%) (70.3% 42.8%) vaccination. Only 6.8% 1.1% received all 3 vaccines. odds were lower among drug tobacco users. People high-risk medical conditions, particularly insured, commonly vaccinated. Conclusions. Marked exist insured people. Understanding structural barriers, Medicaid enrollees, is critical to improving access. ( Am J Public Health. Published online ahead print January 23, 2025:e1–e10. https://doi.org/10.2105/AJPH.2024.307899 )

Language: Английский

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Outcomes Following Extracorporeal Membrane Oxygenation for Severe COVID-19 in Pregnancy or Post Partum

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(5), P. e2314678 - e2314678

Published: May 22, 2023

Importance Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, variable outcomes noted for the maternal-fetal dyad. Objective To examine maternal and perinatal associated ECMO used respiratory failure during pregnancy. Design, Setting, Participants This retrospective multicenter cohort study examined postpartum required at 25 hospitals across US. Eligible included individuals received care one sites, were diagnosed SARS-CoV-2 infection pregnancy or up to 6 weeks post partum by positive nucleic acid antigen test, whom was initiated from March 1, 2020, October 2022. Exposures in setting failure. Main outcome measures The primary mortality. Secondary serious morbidity, obstetrical outcomes, neonatal outcomes. Outcomes compared timing partum, initiation periods circulation variants. Results From 2022, 100 started on (29 [29.0%] Hispanic, [25.0%] non-Hispanic Black, 34 [34.0%] White; mean [SD] age: 31.1 [5.5] years), including 47 (47.0%) pregnancy, 21 (21.0%) within 24 hours 32 (32.0%) between partum; 79 (79.0%) had obesity, 61 (61.0%) public no insurance, 67 (67.0%) did not have an immunocompromising condition. median (IQR) run 20 (9-49) days. There 16 deaths (16.0%; 95% CI, 8.2%-23.8%) cohort, 76 (76.0%; 58.9%-93.1%) 1 more morbidity events. largest venous thromboembolism occurred 39 (39.0%), which similar (40.4% [19 47] vs 38.1% [8 21] immediately 37.5% [12 32]; P > .99). Conclusions Relevance In this US COVID-19–associated failure, most survived but experienced a high frequency morbidity.

Language: Английский

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Maternal and neonatal outcomes following SARS-CoV-2 infection

Seminars in Fetal and Neonatal Medicine, Journal Year: 2023, Volume and Issue: 28(1), P. 101428 - 101428

Published: Feb. 1, 2023

Language: Английский

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Safety and Effectiveness of COVID-19 Vaccines During Pregnancy: A Living Systematic Review and Meta-analysis

Drug Safety, Journal Year: 2024, Volume and Issue: 47(10), P. 991 - 1010

Published: July 15, 2024

Pregnant persons are susceptible to significant complications following COVID-19, even death. However, worldwide COVID-19 vaccination coverage during pregnancy remains suboptimal.

Language: Английский

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Covid-19 infection and vaccination during first trimester and risk of congenital anomalies: Nordic registry based study

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e079364 - e079364

Published: July 17, 2024

To evaluate the risk of major congenital anomalies according to infection with or vaccination against covid-19 during first trimester pregnancy. Prospective Nordic registry based study. Sweden, Denmark, and Norway. 343 066 liveborn singleton infants in Norway, an estimated start pregnancy between 1 March 2020 14 February 2022, identified using national health registries. Major were categorised EUROCAT (European Surveillance Congenital Anomalies) definitions. The after was assessed by logistic regression, adjusting for maternal age, parity, education, income, country origin, smoking, body mass index, chronic conditions, date 17 704 (5.2%) had a anomaly. When evaluating associated trimester, adjusted odds ratio ranged from 0.84 (95% confidence interval 0.51 1.40) eye 1.12 (0.68 1.84) oro-facial clefts. Similarly, (0.31 2.31) nervous system 1.69 (0.76 3.78) abdominal wall defects. Estimates 10 11 subgroups less than 1.04, indicating no notable increased risk. Covid-19 not anomalies.

Language: Английский

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Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

BMC Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: March 13, 2024

Abstract Background Experiences during childhood and adolescence have enduring impacts on physical mental well-being, overall quality of life, socioeconomic status throughout one’s lifetime. This underscores the importance prioritizing health children adolescents to establish an impactful healthcare system that benefits both individuals society. It is crucial for providers policymakers examine relationship between COVID-19 adolescents, as this understanding will guide creation interventions policies long-term management virus. Methods In umbrella review (PROSPERO ID: CRD42023401106), systematic reviews were identified from Cochrane Database Systematic Reviews; EMBASE (OvidSP); MEDLINE (OvidSP) December 2019 February 2023. Pairwise single-arm meta-analyses extracted included reviews. The methodological appraisal was completed using AMSTAR-2 tool. Single-arm re-presented under six domains associated with condition. classified into five according evidence classification criteria. Rosenberg’s FSN calculated binary continuous measures. Results We 1551 301 pairwise 124 met our predefined criteria inclusion. focus meta-analytical predominantly outcomes COVID-19, encompassing study designs. However, rigor suboptimal. Based gathered meta-analyses, we constructed illustrative representation disease severity, clinical manifestations, laboratory radiological findings, treatments, 2020 2022. Additionally, discovered 17 instances strong or highly suggestive concerning long-COVID, pediatric comorbidity, vaccines, health, depression. Conclusions findings advocate implementation surveillance systems track consequences establishment multidisciplinary collaborative rehabilitation programs affected younger populations. future research endeavors, it important prioritize investigation non-physical bridge gap application in field.

Language: Английский

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Outcomes of SARS‐CoV‐2 infection in early pregnancy—A systematic review and meta‐analysis

Acta Obstetricia Et Gynecologica Scandinavica, Journal Year: 2024, Volume and Issue: 103(5), P. 786 - 798

Published: Jan. 10, 2024

Abstract Introduction Available data on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and pregnancy outcomes mostly refer to women contracting the during advanced or close delivery. There is limited information association between SARS‐CoV‐2 in early thereof. Material methods We aimed systematically review maternal, fetal neonatal following pregnancy, defined as <20 weeks of gestation (PROSPERO Registration 2020 CRD42020177673). Searches were carried out PubMed, Medline, EMBASE, Scopus databases from January until April 2023 WHO database publications disease 2019 (COVID‐19) December 2023. Cohort case–control studies COVID‐19 occurring that reported fetal, included. Case reports reporting only exposure not stratifying based gestational age excluded. Data extracted duplicate. Meta‐analyses conducted when appropriate, using R meta (R version 4.0.5). Results A total 18 studies, 12 retrospective six prospective, included this review, 10 147 SARS‐CoV‐2‐positive infected 9533 neonates, 180 882 negative women. The had low moderate risk bias according Newcastle–Ottawa quality assessment Scale. showed significant clinical methodological heterogeneity. meta‐analysis could be performed outcome miscarriage rate, with a pooled random effect odds ratio 1.44 (95% confidence interval 0.96–2.18), showing no statistical difference SARS‐CoV‐2‐infected Individual increased incidences stillbirth, birthweight preterm birth among neonates born mothers affected by pregnancy; however, these results consistent all studies. Conclusions In comprehensive systematic available evidence, we identified statistically adverse (before 20 gestation) neonatal, maternal outcomes. However, 44% increase rate concerning further larger sample size are needed confirm refute our findings.

Language: Английский

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Preeclampsia in the Context of COVID‐19: Mechanisms, Pathophysiology, and Clinical Outcomes

American Journal of Reproductive Immunology, Journal Year: 2024, Volume and Issue: 92(2)

Published: Aug. 1, 2024

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to global COVID-19 pandemic, significantly impacting health pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on potential correlation between preeclampsia (PE), a leading cause maternal perinatal worldwide, emphasizing significance exploring relationship these two conditions. Here, we review pathophysiological similarities that PE shares with particular focus cases in PE-like SARS-CoV-2 infection. We highlight cellular molecular mechanistic inter-connectivity conditions, for example, regulation renin-angiotensin system, tight junction barrier integrity, complement system. Finally, discuss how pandemic dynamics, including variants vaccination efforts, shaped clinical scenario influenced severity management both PE. Continued research mechanisms infection during pregnancy risk developing from previous infections is warranted delineate complexities interactions improve

Language: Английский

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