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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Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

Nature Human Behaviour, Год журнала: 2023, Номер 7(4), С. 529 - 544

Опубликована: Фев. 27, 2023

Abstract Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported many countries following early COVID-19 pandemic response measures (‘lockdowns’). It unclear whether this variation reflects real differences lockdown impacts, or perhaps stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data 52 million births 26 countries, 18 which had representative population-based data, with overall 6% 12% 2.5 10.5 per 1,000 births. We show small reductions first (odds ratio 0.96, 95% confidence interval 0.95–0.98, P value <0.0001), second (0.96, 0.92–0.99, 0.03) third (0.97, 0.94–1.00, 0.09) months lockdown, but not fourth month (0.99, 0.96–1.01, 0.34), although there some between-country after month. For high-income study, did observe an association between stillbirths (1.00, 0.88–1.14, 0.98), 0.88–1.12, 0.89) (1.01, 0.87–1.18, 0.86) have imprecise estimates due being a relatively rare event. did, however, find evidence increased risk (1.14, 1.02–1.29, 0.02) and, Brazil, found for (1.09, 1.03–1.15, 0.002), (1.10, 1.03–1.17, 0.003) (1.12, 1.05–1.19, <0.001) lockdown. With estimated 14.8 annually worldwide, modest observed during lockdowns translate into large numbers averted globally warrant further research causal pathways.

Язык: Английский

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Infections and Pregnancy: Effects on Maternal and Child Health

Frontiers in Cellular and Infection Microbiology, Год журнала: 2022, Номер 12

Опубликована: Июнь 8, 2022

Pregnancy causes physiological and immunological adaptations that allow the mother fetus to communicate with precision in order promote a healthy pregnancy. At same time, these may make pregnant women more susceptible infections, resulting variety of pregnancy complications; those pathogens also be vertically transmitted fetus, adverse outcomes. Even though placenta has developed robust microbial defense restrict vertical transmission, certain have evolved mechanisms avoid placental barrier cause congenital diseases. Recent mechanistic studies begun uncover striking role maternal microbiota In this review, we discuss how overcome A better understanding control fetal infection should provide new insights into future translational research.

Язык: Английский

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Obstetric interventions and pregnancy outcomes during the COVID-19 pandemic in England: A nationwide cohort study

PLoS Medicine, Год журнала: 2022, Номер 19(1), С. e1003884 - e1003884

Опубликована: Янв. 10, 2022

Background The COVID-19 pandemic has disrupted maternity services worldwide and imposed restrictions on societal behaviours. This national study aimed to compare obstetric intervention pregnancy outcome rates in England during the corresponding pre-pandemic calendar periods, assess whether differences these varied according ethnic socioeconomic background. Methods findings We conducted a of singleton births English National Health Service hospitals. compared period (23 March 2020 22 February 2021) with 1 year earlier. Hospital Episode Statistics database provided administrative hospital data about maternal characteristics, inventions (induction labour, elective or emergency cesarean section, instrumental birth), outcomes (stillbirth, preterm birth, small for gestational age [SGA; birthweight < 10th centile], prolonged length stay (≥3 days), 42-day readmission). Multi-level logistic regression models were used between periods test interactions All adjusted characteristics including age, history, comorbidities, status at birth. included 948,020 (maternal characteristics: median 30 years, 41.6% primiparous, 8.3% diabetes, 2.4% preeclampsia, 1.6% pre-existing diabetes hypertension); 451,727 occurred defined period. Maternal similar periods. Compared period, stillbirth remained (0.36% versus 0.37% pre-pandemic, p = 0.16). Preterm birth SGA slightly lower (6.0% 6.1% births, odds ratio [aOR] 0.96, 95% CI 0.94–0.97; 5.6% 5.8% aOR 0.95, 0.93–0.96; both 0.001). Slightly higher observed (40.4% 39.1% induction 1.04, 1.03–1.05; 13.9% 12.9% 1.13, 1.11–1.14; 18.4% 17.0% 1.07, 1.06–1.08; all Lower (16.7% 20.2%, 0.77, 0.76–0.78, 0.001) readmission (3.0% 3.3%, 0.88, 0.86–0.90, There was some evidence that unassisted vaginal mother’s background but not her A key limitation is multiple comparisons made, increasing chance false-positive results. Conclusions In this study, we found very decreases increases labour section pandemic, different pattern results women from minority backgrounds. These changes may be linked women’s behaviour, environmental exposure, practice, reduced staffing levels.

Язык: Английский

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Maternal immune response and placental antibody transfer after COVID-19 vaccination across trimester and platforms

Nature Communications, Год журнала: 2022, Номер 13(1)

Опубликована: Июнь 28, 2022

The availability of three COVID-19 vaccines in the United States provides an unprecedented opportunity to examine how vaccine platforms and timing vaccination pregnancy impact maternal neonatal immunity. Here, we characterize antibody profile after Ad26.COV2.S, mRNA-1273 or BNT162b2 158 pregnant individuals evaluate transplacental transfer by profiling umbilical cord blood 175 maternal-neonatal dyads. These analyses reveal lower vaccine-induced functions Fc receptor-binding Ad26.COV2.S compared mRNA subtle advantages titer function with versus BN162b2. have higher titers against SARS-CoV-2 variants concern. First third trimester results enhanced antibody-dependent NK-cell activation, cellular neutrophil phagocytosis, complement deposition relative second trimester. Higher ratios following first may reflect placental compensation for waning titers. provide novel insight into platform on humoral immune response transfer.

Язык: Английский

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