Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes

JAMA, Год журнала: 2022, Номер 327(15), С. 1478 - 1478

Опубликована: Март 24, 2022

There is limited comparative epidemiological evidence on outcomes associated with COVID-19 vaccination during pregnancy; monitoring pregnancy in large populations required.To evaluate peripartum following pregnancy.Population-based retrospective cohort study Ontario, Canada, using a birth registry linked the provincial immunization database. All births between December 14, 2020, and September 30, 2021, were included.COVID-19 pregnancy, after no vaccination.Postpartum hemorrhage, chorioamnionitis, cesarean delivery (overall emergency delivery), admission to neonatal intensive care unit (NICU), low newborn 5-minute Apgar score (<7). Linear robust Poisson regression was used generate adjusted risk differences (aRDs) ratios (aRRs), respectively, comparing cumulative incidence of those who received vaccinated record at any point. Inverse probability treatment weights adjust for confounding.Among 97 590 individuals (mean [SD] age, 31.9 [4.9] years), 22 660 (23%) least 1 dose vaccine (63.6% third trimester; 99.8% an mRNA vaccine). Comparing vs (n = 44 815), there significantly increased risks postpartum hemorrhage (incidence: 3.0% 3.0%; aRD, -0.28 per 100 [95% CI, -0.59 0.03]; aRR, 0.91 0.82-1.02]), chorioamnionitis (0.5% 0.5%; -0.04 -0.17 0.09]; 0.92 0.70-1.21]), (30.8% 32.2%; -2.73 -3.59 -1.88]; 0.89-0.95]), NICU (11.0% 13.3%; -1.89 newborns -2.49 -1.30]; 0.85 0.80-0.90]), or (1.8% 2.0%; -0.31 -0.56 -0.06]; 0.84 0.73-0.97]). Findings qualitatively similar when compared did not receive point 30 115).In this population-based vaccination, adverse outcomes. Study interpretation should consider that vaccinations primarily vaccines administered second trimester.

Язык: Английский

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Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis

BMJ Global Health, Год журнала: 2023, Номер 8(1), С. e009495 - e009495

Опубликована: Янв. 1, 2023

Despite a growing body of research on the risks SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in quality and design published studies.

Язык: Английский

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Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study

The Lancet, Год журнала: 2023, Номер 401(10375), С. 447 - 457

Опубликована: Янв. 18, 2023

Язык: Английский

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Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic

JAMA Network Open, Год журнала: 2021, Номер 4(8), С. e2120456 - e2120456

Опубликована: Авг. 11, 2021

Importance

Prior studies on COVID-19 and pregnancy have reported higher rates of cesarean delivery preterm birth increased morbidity mortality. Additional data encompassing a longer time period are needed.

Objective

To examine characteristics outcomes large US cohort women who underwent childbirth with vs without COVID-19.

Design, Setting, Participants

This study compared (age ≥18 years) between March 1, 2020, February 28, 2021, at 499 academic medical centers or community affiliates. Follow-up was limited to in-hospital course discharge destination. Childbirth defined by clinical classification software procedural codes 134-137. A diagnosis identified usingInternational Statistical Classification Diseases Related Health Problems, Tenth Revision(ICD-10) U07.1. Data were analyzed from April 1 30, 2021.

Exposures

The presence usingICD-10.

Main Outcomes Measures

Analyses demographic characteristics, gestational age, comorbidities. primary outcome Secondary included hospital length stay, intensive care unit (ICU) admission, mechanical ventilation, status. Continuous variables usingttest, categorical using χ².

Results

Among 869 079 women, 18 715 (2.2%) had COVID-19, 850 364 (97.8%) did not. Most aged 30 years (11 550 [61.7%]; 447 534 [52.6%]) White (8060 [43.1%] in the cohort; 501 (58.7%) non–COVID-19 cohort). There no significant increase among (6088 [32.5%] 273 810 [32.3%];P = .57). Women more likely (3072 [16.4%] 97 967 [11.5%];P < .001). giving significantly ICU admission (977 [5.2%] 7943 [0.9%]; odds ratio [OR], 5.84 [95% CI, 5.46-6.25];P .001), respiratory intubation ventilation (275 [1.5%] 884 [0.1%]; OR, 14.33 12.50-16.42];P mortality (24 [0.1%] 71 [<0.01%]; 15.38 9.68-24.43];P

Conclusions Relevance

retrospective found that mortality, intubation, than

Язык: Английский

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COVID-19 in pregnancy: implications for fetal brain development

Trends in Molecular Medicine, Год журнала: 2022, Номер 28(4), С. 319 - 330

Опубликована: Фев. 14, 2022

The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy on the developing fetal brain is poorly understood. Other antenatal infections such as influenza have been associated with adverse neurodevelopmental outcomes in offspring. Although vertical transmission has rarely observed SARS-CoV-2 to date, given potential for profound maternal immune activation (MIA), likely. Here we review evidence that and other viral can result maternal, placental, activation, ultimately offspring morbidity. Finally, highlight need cellular models development better understand short- long-term impacts next generation.

Язык: Английский

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Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development

BMC Medicine, Год журнала: 2022, Номер 20(1)

Опубликована: Фев. 4, 2022

A substantial portion of people with COVID-19 subsequently experience lasting symptoms including fatigue, shortness breath, and neurological complaints such as cognitive dysfunction many months after acute infection. Emerging evidence suggests that this condition, commonly referred to long COVID but also known post-acute sequelae SARS-CoV-2 infection (PASC) or post-COVID-19 could become a significant global health burden.While the number studies investigating condition is increasing, there no agreement on how new disease should be defined diagnosed in clinical practice what relevant outcomes measure. There an urgent need optimise standardise outcome measures for important patient group both services research allow comparing pooling data.A Core Outcome Set developed shortest time frame possible, improvement data quality, harmonisation, comparability between different geographical locations. We call initiative, involving all partners, including, not limited to, healthcare professionals, researchers, methodologists, patients, caregivers. urge coordinated actions aiming develop (COS) adult paediatric populations.

Язык: Английский

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Mechanisms of action of fluvoxamine for COVID-19: a historical review

Molecular Psychiatry, Год журнала: 2022, Номер 27(4), С. 1898 - 1907

Опубликована: Янв. 7, 2022

Язык: Английский

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Antibodies elicited by SARS-CoV-2 infection or mRNA vaccines have reduced neutralizing activity against Beta and Omicron pseudoviruses

Science Translational Medicine, Год журнала: 2022, Номер 14(634)

Опубликована: Янв. 14, 2022

Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that have mutations associated with increased transmission and antibody escape arisen over the course of current pandemic. Although vaccines largely been effective against past variants, number found on Omicron (B.1.1.529) spike protein appear to diminish protection conferred by preexisting immunity. Using vesicular stomatitis virus (VSV) pseudoparticles expressing several SARS-CoV-2 we evaluated magnitude breadth neutralizing response time in individuals after infection mRNA-vaccinated individuals. We observed boosting increases wild-type (D614), Beta, Delta, variants; however, variant was most resistant neutralization. further vaccinated healthy adults had robust broad responses, whereas responses may reduced pregnant women, underscoring importance learning how maximize mRNA vaccine populations. Findings from this study show substantial heterogeneity vaccination support addition more conserved viral antigens existing vaccines.

Язык: Английский

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Covid-19 vaccination in pregnancy

BMJ, Год журнала: 2022, Номер unknown, С. e069741 - e069741

Опубликована: Авг. 10, 2022

ABSTRACT Pregnancy is an independent risk factor for severe covid-19. Vaccination the best way to reduce SARS-CoV-2 infection and limit its morbidity mortality. The current recommendations from World Health Organization, Centers Disease Control Prevention, professional organizations are pregnant, postpartum, lactating women receive covid-19 vaccination. specific considerations involve potential effects of vaccination on fetal development, placental transfer antibodies, safety maternal Although pregnancy was exclusion criterion in initial clinical trials vaccines, observational data have been rapidly accumulating thus far confirm that benefits outweigh risks. This review examines evidence supporting effectiveness, immunogenicity, transfer, side effects, perinatal outcomes Additionally, it describes factors associated with vaccine hesitancy pregnancy. Overall, studies monitoring people who received vaccines during not identified any concerns. Additional information non-mRNA early pregnancy, longer term infants needed. To collect this information, must be prioritized research.

Язык: Английский

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A Prospective Cohort Study of COVID-19 Vaccination, SARS-CoV-2 Infection, and Fertility

American Journal of Epidemiology, Год журнала: 2022, Номер 191(8), С. 1383 - 1395

Опубликована: Янв. 14, 2022

Some reproductive-aged individuals remain unvaccinated against coronavirus disease 2019 (COVID-19) because of concerns about potential adverse effects on fertility. Using data from an internet-based preconception cohort study, we examined the associations COVID-19 vaccination and severe acute respiratory syndrome 2 (SARS-CoV-2) infection with fertility among couples trying to conceive spontaneously. We enrolled 2,126 self-identified female participants aged 21-45 year residing in United States or Canada during December 2020-September 2021 followed them through November 2021. Participants completed questionnaires every 8 weeks sociodemographics, lifestyle, medical factors, partner information. fit proportional probabilities regression models estimate between self-reported SARS-CoV-2 both partners fecundability (i.e., per-cycle probability conception), adjusting for confounders. was not appreciably associated either (female ratio (FR) = 1.08, 95% confidence interval (CI): 0.95, 1.23; male FR CI: 0.83, 1.10). Female strongly (FR 1.07, 0.87, 1.31). Male a transient reduction (for within 60 days, 0.82, 0.47, 1.45; after 1.16, 0.92, 1.47). These findings indicate that may be short-term decline does impair partner.

Язык: Английский

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