Obstetric Complications and Birth Outcomes After Antenatal Coronavirus Disease 2019 (COVID-19) Vaccination

Obstetrics and Gynecology, Год журнала: 2024, Номер unknown

Опубликована: Апрель 16, 2024

OBJECTIVE: To evaluate the association between antenatal messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination and risk of adverse pregnancy outcomes. METHODS: This was a retrospective cohort study individuals with singleton pregnancies live deliveries June 1, 2021, January 31, 2022, data available from eight integrated health care systems in Vaccine Safety Datalink. exposure defined as receipt one or two mRNA COVID-19 vaccine doses (primary series) during pregnancy. Outcomes were preterm birth (PTB) before 37 weeks gestation, small-for-gestational age (SGA) neonates, gestational diabetes mellitus (GDM), hypertension, preeclampsia–eclampsia–HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome. vaccinated compared those propensity-matched unexposed pregnancies. Adjusted hazard ratios (aHRs) 95% CIs estimated for PTB SGA using time-dependent covariate Cox model, adjusted relative risks (aRRs) GDM, syndrome Poisson regression robust variance. RESULTS: Among 55,591 eligible inclusion, 23,517 (42.3%) received Receipt varied by maternal age, race, Hispanic ethnicity, history COVID-19. Compared no vaccination, associated decreased (rate: 6.4 [vaccinated] vs 7.7 [unvaccinated] per 100, aHR 0.89; CI, 0.83–0.94). Messenger not (8.3 7.4 100; 1.06, 0.99–1.13), GDM (11.9 10.6 aRR 1.00, 0.90–1.10), hypertension (10.8 9.9 1.08, 0.96–1.22), (8.9 8.4 1.10, 0.97–1.24). CONCLUSION: an increased outcomes; this information will be helpful patients clinicians when considering

Язык: Английский

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Preeclamptic Placental CD19+ B Cells Are Causal to Hypertension During Pregnancy

Hypertension, Год журнала: 2025, Номер unknown

Опубликована: Апрель 2, 2025

BACKGROUND: Patients with preeclampsia exhibit hypertension and chronic inflammation characterized by CD (cluster determinant) 4+T cells, B cells secreting AT1-AA (agonistic autoantibody against the angiotensin II type 1 receptor), inflammatory cytokines, complement activation. Importantly, a history of COVID-19 during pregnancy is associated an increased incidence preeclampsia-like phenotype partly mediated CD4+T cells. We recently showed pregnant patients or without produce AT1-AA, indicating importance lymphocytes in progression possibly COVID-19. Therefore, we hypothesize that from induce through AT1-AA. METHODS: Placental were isolated normal pregnant, preeclampsia, normotensive history, at delivery. Then, 3×10 5 transferred intraperitoneally into athymic rats gestational day 12. On 18, carotid catheters inserted. 19, mean arterial pressure was measured, tissues collected. RESULTS: Preeclampsia B-cell recipients had significantly pressure, activation compared recipients. Recipients markers but not to level significance as Inhibition attenuated occurred response history. CONCLUSIONS: This study demonstrates important role contributing secretion

Язык: Английский

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Symptomatic COVID-19 in Pregnancy: Hospital Cohort Data between May 2020 and April 2021, Risk Factors and Medicolegal Implications

Diagnostics, Год журнала: 2023, Номер 13(6), С. 1009 - 1009

Опубликована: Март 7, 2023

Pregnancy does not appear to increase susceptibility SARS-CoV-2 infection, but some physiological changes, such as the reduction of residual functional volumes, elevation diaphragm, and impaired cellular immunity, may risk severe disease result in a higher complications. The article’s primary objective is evaluate factors associated with symptomatic COVID-19 pregnancy. secondary describe maternal neonatal outcomes cases vertical transmission infection. All pregnant women hospitalized SARS-CoV2 infection were included prospective study UOC Obstetrics Gynecology, AOOR Villa Sofia—Cervello, Palermo, between May 2020 April 2021. patients who requested termination pregnancy according Law 194/78 excluded. We 165 pregnancies total number 134 deliveries. Overall, 88.5% asymptomatic at time admission 11.5% symptomatic. Of them, 1.8% required hospital intensive care unit. Symptoms occurrences positively BMI (OR 1.17; p = 0.002), prematurity 4.71; 0.022), lower birth weight 0.99; 0.007). One infant tested positive for nasopharyngeal swab; 11.4% newborns had IgG anti birth; IgM was 2.4% newborns. There no difference statistically significant among group that women.

Язык: Английский

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Facilitators and Barriers to Vaccination Uptake in Pregnancy: A Qualitative Systematic Review

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Янв. 9, 2024

Introduction Vaccination during pregnancy protects both the mother and foetus from vaccine-preventable diseases. However, uptake of recommended vaccines (influenza, pertussis, COVID-19) by pregnant women remains low in Europe USA. Understanding reasons for this is crucial to inform strategies increase vaccination rates women. This qualitative systematic review aimed identify barriers facilitators against influenza, pertussis/whooping cough COVID-19 possible rates. Methods We conducted a comprehensive search electronic databases, including Medline, PsycINFO, CINAHL, Web Science, WHO database, Embase grey literature studies that explored vaccine among (PROSPERO CRD42023399488). The was limited published between 2012 2022 high-income countries with established programmes pregnancy. Studies were thematically analysed underwent quality assessment using Joanna Briggs Institute validated critical appraisal tool research. Results Out 2681 articles screened, 28 (n=1573 participants) eligible inclusion. Five overarching themes emerged relating personal, provider systemic factors. Barriers included concerns about safety efficacy, lack knowledge vaccines’ benefits necessity, fear adverse effects on or perception disease severity. Facilitators recommendations trusted healthcare providers, easy access vaccination, clear communication positive social influences family friends. Strategies increasing strong proactive professionals, provision routine antenatal care, consistent addressing women’s concerns. Conclusion highlights need interventions address identified Recommendation can play significant role promoting uptake, as risk/benefit convenient vaccination. Addressing providing accurate information also important.

Язык: Английский

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“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

BMC Public Health, Год журнала: 2023, Номер 23(1)

Опубликована: Июль 21, 2023

Abstract Background Maternal vaccinations against Influenza, Pertussis, and Covid-19 are recommended in the UK, vaccines further infections may become available soon. However, many pregnant women, especially socially ethnically diverse areas, have low vaccine uptake. Qualitative studies on reasons possible solutions needed that inclusive of disadvantaged minority ethnic groups. We therefore aimed to understand complex interplay between structural behavioural factors contributing maternal uptake areas London context. Methods In 2022, we conducted semi-structured interviews a focus group discussion among purposive sample 38 pregnant/recently women 20 health service providers, including 12 midwives. Participants were recruited boroughs. followed critical realist paradigm used thematic analysis approach. Results The included participants who took all, some or none vaccines, with unsure whether they had taken been offered vaccines. Decision-making was passive active, expectation for do their 'own research'. described various individual, social contextual influences decision-making as navigated antenatal care system. Missing conflicting information from providers meant knowledge gaps sometimes filled misinformation unreliable sources increased uncertainties mistrust. Both organisational hindered access vaccinations, lack training, time resources, shortcomings systems apps. Some facilitated vaccination made recommendations improvements. Conclusions Our study showed how can compound around populations. highlight need more reliable streamlined workflows, improved electronic training use. Roles responsibilities should be clarified potential greater involvement nurses pharmacists provision. Education communication consider individual (language/digital) skills needs reassurance. Further research is co-produce users providers.

Язык: Английский

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Vaccination, immunity, and the changing impact of COVID-19 on infant health

Proceedings of the National Academy of Sciences, Год журнала: 2023, Номер 120(49)

Опубликована: Ноя. 27, 2023

In utero exposure to COVID-19 infection may lead large intergenerational health effects. The impact of has likely evolved since the onset pandemic as new variants emerge, immunity from prior increases, vaccines become available, and vaccine hesitancy persists, such that

Язык: Английский

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Maternal COVID-19 vaccination status and association with neonatal congenital anomalies

Frontiers in Pediatrics, Год журнала: 2024, Номер 12

Опубликована: Апрель 19, 2024

Introduction Despite recommendations for COVID-19 vaccination in pregnant people, the effect of on neonatal outcomes remains unknown. We sought to determine association between status pregnancy and presence neonatally diagnosed congenital anomalies. Methods A comprehensive vaccine registry was combined with a delivery database create cohort including all patients aged 16–55 years event December 10, 2020 31, 2021 at hospital within Mayo Clinic Health System. Pregnancy were analyzed relation timing, composite measure anomalies life. Comparisons cohorts conducted using chi-square test categorical Kruskal–Wallis continuous variables. multivariable logistic regression modeled assess Results 5,096 mother-infant pairs analyzed. total 1,158 vaccinated, 314 vaccinated first trimester. status, during trimester pregnancy, not associated an increased risk When further examining by organ system, we did demonstrate significant difference eye, ear, face, neck groups (Table 3, Not = 2.3%, Vaccinated 3.3%, p -value 0.04) however this 1st (Not Trimester 2.5%, 0.77). No differences found or any other systems. There no birthweight gestational age, APGAR scores, incidence NICU admission, living neonate status. Conclusion add additional information regarding safety timing as it pertains anomalies, demonstrated. Our findings agree prior literature that is adverse small age neonates. Further research needed elucidate neck,

Язык: Английский

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What factors influence the uptake of vaccinations amongst pregnant women following the Covid-19 pandemic: A qualitative study

Midwifery, Год журнала: 2024, Номер 134, С. 104021 - 104021

Опубликована: Апрель 29, 2024

Pregnant women and their unborn babies are at increased risk from serious complications, hospitalisation death infectious diseases. Vaccinations for influenza (flu), pertussis (whooping cough) Covid-19 available free pregnant in the UK, but uptake of these repeatedly remains low. This qualitative study aimed to explore how feel about vaccinations, what factors influence vaccinations amongst since onset pandemic.

Язык: Английский

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Maternal hybrid immunity and risk of infant COVID-19 hospitalizations: national case-control study in Israel

Nature Communications, Год журнала: 2024, Номер 15(1)

Опубликована: Апрель 2, 2024

Abstract Hybrid immunity, acquired through vaccination followed or preceded by a COVID-19 infection, elicits robust antibody augmentation. We hypothesize that maternal hybrid immunity will provide greater infant protection than other forms of in the first 6 months life. conducted case-control study Israel, enrolling 661 infants up to age, hospitalized with (cases) and 59,460 age-matched non-hospitalized (controls) between August 24, 2021, March 15, 2022. Infants were grouped status at delivery: Naïve (never vaccinated tested positive, reference group), Hybrid-immunity (vaccinated positive), Natural-immunity (tested positive before during period), Full-vaccination (two-shot regimen plus 1 booster), Partial-vaccination (less full three shot regimen). Applying Cox proportional hazards models estimate hazard ratios, which was then converted percent vaccine effectiveness, using group as reference, hybrid-immunity provided highest (84% [95% CI 75-90]), full-vaccination (66% 56-74]), natural-immunity (56% 39-68]), partial-vaccination (29% 15-41]). Maternal associated reduced risk hospitalization for Covid-19, compared natural-immunity, regardless exposure timing sequence. These findings emphasize benefits vaccinating previously infected individuals pregnancy reduce hospitalizations early infancy.

Язык: Английский

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Predicting adverse outcomes in pregnant patients positive for SARS-CoV-2: a machine learning approach- a retrospective cohort study

BMC Pregnancy and Childbirth, Год журнала: 2023, Номер 23(1)

Опубликована: Авг. 2, 2023

Abstract Background Pregnant people are particularly vulnerable to SARS-CoV-2 infection and ensuing severe illness. Predicting adverse maternal perinatal outcomes could aid clinicians in deciding on hospital admission early initiation of treatment affected individuals, streamlining the triaging processes. Methods An international repository 1501 SARS-CoV-2-positive cases pregnancy was created, consisting demographic variables, patient comorbidities, laboratory markers, respiratory parameters, COVID-19-related symptoms. Data were filtered, preprocessed, feature selection methods used obtain optimal subset for training a variety machine learning models predict or fetal/neonatal death critical Results The Random Forest model demonstrated best performance among trained models, correctly identifying 83.3% high-risk patients 92.5% low-risk patients, with an overall accuracy 89.0%, AUC 0.90 (95% Confidence Interval 0.83 0.95), recall, precision, F1 score 0.85, 0.94, 0.89, respectively. This achieved using 25 features containing characteristics, symptoms, clinical signs, markers. These included BMI, gravidity, parity, existence pre-existing conditions, nicotine exposure, anti-hypertensive medication administration, fetal malformations, antenatal corticosteroid presence dyspnea, sore throat, fever, fatigue, duration symptom phase, pneumonia, need oxygen disease-related inpatient treatment, lab markers including sFLT-1/PlGF ratio, platelet count, LDH. Conclusions We present first COVID-19 prognostication pipeline specifically pregnant while utilizing large data repository. Our accurately identifies those at risk illness deterioration, presenting promising tool advancing personalized medicine COVID-19.

Язык: Английский

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