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Ahmed S, Liu G, Sadiq A, Yang H, Yongbin L, Farooq U, Yi D, Yiyu S, Xiaodong W, Ahmed M, Jiang X. Synergistic Effect of Maternal Micronutrient Supplementation on ORFV DNA Vaccine Immune Response in a Pregnant Model. Biol Trace Elem Res 2024:10.1007/s12011-024-04263-9. [PMID: 38874865 DOI: 10.1007/s12011-024-04263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
Contagious ecthyma is a contagious zoonotic disease caused by the Orf virus that can infect farm animals and humans, but no vaccine is available for pregnant mothers. Excessive oxidative stress during pregnancy can suppress the vaccine immune response in pregnant mothers; hence, maternal micronutrient supplementation could effectively improve the immune response, health, and oxidative status during pregnancy. In this study, we employed an 8-week-old pregnant rat model to receive a single intramuscular dose of 200 µg of ORF DNA vaccine with or without vitamin E and selenium supplementation to evaluate their effect on immune responses (specific IgG and IgG isotypes), oxidative stress, liver enzymes, and blood glucose levels in maternal-neonatal serum and milk secretions. Additionally, antioxidant-related gene expressions were analyzed in the maternal placenta and pups' liver. The results showed that supplementation of vitamin E and selenium with ORF DNA vaccination increased the production of specific antibody and IgG isotypes (IgG1 and IgG2a) and reduced the oxidative stress in neonatal-maternal serum and milk compared to both the control group and those vaccinated without supplementation (p < 0.05). Notably, the ORF DNA vaccine did not cause oxidative stress and hepatic damage. However, combined supplementation of vitamin E and selenium with DNA vaccination significantly decreased serum malondialdehyde (MDA) levels and improved the antioxidant-related enzyme activities of glutathione peroxidase (GPX), superoxide dismutase 1 (SOD1), and selenoprotein P (SELP) in the maternal placenta and liver of pups (p < 0.05). In conclusion, maternal supplementation of vitamin E and selenium enhanced the immune responses of the ORF DNA vaccine by mitigating oxidative stress in pregnant rats and could thus be a promising strategy for better health outcomes for both mothers and neonates.
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Affiliation(s)
- Sohail Ahmed
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
- Laboratory of Sheep and Goat Genetics, Breeding and Reproduction, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Guiqiong Liu
- Laboratory of Sheep and Goat Genetics, Breeding and Reproduction, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Amber Sadiq
- Department of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan
| | - Huiguo Yang
- Xinjiang Academy of Animal Sciences, Urumqi, China
| | - Liu Yongbin
- College of Life Sciences, Inner Mongolia University, Hohhot, China
| | - Umar Farooq
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Ding Yi
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
- Laboratory of Sheep and Goat Genetics, Breeding and Reproduction, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Sha Yiyu
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
- Laboratory of Sheep and Goat Genetics, Breeding and Reproduction, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Wang Xiaodong
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Mehboob Ahmed
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Xunping Jiang
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China.
- Laboratory of Sheep and Goat Genetics, Breeding and Reproduction, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China.
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Seravalli V, Romualdi I, Ammar O, De Blasi C, Boccalini S, Bechini A, Di Tommaso M. Vaccination coverage during pregnancy and factors associated with refusal of recommended vaccinations: An Italian cross sectional study. Vaccine X 2024; 18:100483. [PMID: 38623567 PMCID: PMC11016930 DOI: 10.1016/j.jvacx.2024.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024] Open
Abstract
Background The vaccines recommended during pregnancy are the Tdap, the influenza vaccine, and, during the SARS-CoV-2 pandemic, the vaccine against COVID-19. This survey aimed at determining vaccination coverage among pregnant women and adverse events, reasons for vaccine refusal, and factors associated with vaccine uptake. Methods A single-center cross-sectional study was conducted on women who delivered between March and April 2022 at Careggi University Hospital in Florence, Italy. Information on the vaccinations (Tdap, influenza and COVID-19) received during pregnancy were collected through in-person interviews. Results Among 307 enrolled women (response rate 99 % on a study population of 310 eligible women), 74 % of patients were vaccinated with Tdap, 82 % against COVID-19, and only 33 % against influenza. Vaccination coverage for Tdap and COVID-19 was significantly higher among Italian than foreign patients (80 % vs 51 %, p < 0.001 and 86 % vs 69 %, p = 0.002, respectively), and for Tdap was higher among patients followed in the private vs public care setting. The main reasons behind refusal of vaccinations were low risk perception of influenza (41 %), insufficient information received from the prenatal care provider regarding the Tdap (35 %), and, for the COVID-19, fear of vaccine side effects (64 %), and concerns about effects on the fetus (70 %). Conclusions Adherence to the influenza vaccine was low because of reduced perception of the disease risks. The difference in vaccination coverage between Italians and foreigners is an example of healthcare disparity. Better information provided to patients about vaccines' efficacy and safety is advisable to increase acceptance of recommended vaccines.
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Affiliation(s)
- Viola Seravalli
- Department of Health Sciences, Section of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Irene Romualdi
- Department of Health Sciences, Section of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Oumaima Ammar
- Department of Health Sciences, Section of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Chiara De Blasi
- Department of Health Sciences, Section of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, Section of Hygiene, Preventive Medicine, Nursing and Public Health, University of Florence, Florence, Italy
| | - Angela Bechini
- Department of Health Sciences, Section of Hygiene, Preventive Medicine, Nursing and Public Health, University of Florence, Florence, Italy
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, Section of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
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Ssali A, Namugumya R, Nalubega P, Kyohere M, Seeley J, Doare KL. Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study. BMC Med Ethics 2024; 25:57. [PMID: 38755578 PMCID: PMC11097482 DOI: 10.1186/s12910-024-01055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial. METHODS We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken. RESULTS Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged. CONCLUSION We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in.
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Affiliation(s)
- Agnes Ssali
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
| | - Rita Namugumya
- Makerere University -John Hopkins University Research Collaboration, Kampala, Uganda
| | - Phiona Nalubega
- Makerere University -John Hopkins University Research Collaboration, Kampala, Uganda
| | | | - Janet Seeley
- London School of Hygiene and Tropical Medicine, London, UK
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Álvarez Aldeán J, José Álvarez García F, de la Calle Fernández-Miranda M, Figueras Falcón T, Iofrío de Arce A, López Rojano M, Rivero Calle I, Suy Franch A. Vaccination in pregnancy. Consensus document of the CAV-AEP and the SEGO. An Pediatr (Barc) 2024; 100:268-274. [PMID: 38565447 DOI: 10.1016/j.anpede.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
During pregnancy, physiological changes in the immune response make pregnant women more susceptible to serious infection, increasing the risk for the mother as well as the foetus, newborn and infant. All women should be correctly and fully vaccinated as they enter their reproductive years, especially against diseases such as tetanus, hepatitis B, measles, rubella and varicella. In addition to the recommended vaccines, in risk situations, inactivated vaccines could be administered to women who were not correctly vaccinated before, while attenuated vaccines are contraindicated. Despite the fact that vaccination during pregnancy is a very important preventive measure and the existing recommendations from public health authorities, scientific societies and health professionals, the vaccination coverage could clearly be improved, especially against influenza and SARS-CoV-2, so any health professional involved in the care of pregnant women should proactively recommend these vaccines. The Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines, and the Spanish Society of Gynaecology and Obstetrics (SEGO) recommend vaccination against the following diseases during pregnancy: against influenza and COVID-19, in any trimester of pregnancy and during the postpartum period (up to 6 months post birth) in women not vaccinated during pregnancy; against pertussis, with the Tdap vaccine, between weeks 27 and 36 of gestation (in the CAV-AEP recommendations, preferably between weeks 27 and 28); and against RSV, with RSVPreF, between weeks 24 and 36 of gestation, preferably between weeks 32 and 36.
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Affiliation(s)
- Javier Álvarez Aldeán
- Servicio de Pediatría, Hospital Costa del Sol, Asociación Española de Pediatría (CAV-AEP), Marbella, Málaga, Spain
| | - Francisco José Álvarez García
- Centro de Salud de Llanera, Asturias Departamento de Medicina. Universidad de Oviedo. Asociación Española de Pediatría (CAV-AEP), Oviedo, Spain.
| | - Maria de la Calle Fernández-Miranda
- Sección de Obstetricia, Hospital Universitario la Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Sociedad Española de Ginecología y Obstetricia, Madrid, Spain
| | - Tatiana Figueras Falcón
- Unidad Medicina Materno Fetal, Servicio de Obstetricia y Ginecologia, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas, Sociedad Española de Ginecología y Obstetricia, Las Palmas de Gran Canaria, Spain
| | - Antonio Iofrío de Arce
- Centro de Salud El Ranero, Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP), Murcia, Spain
| | - Marta López Rojano
- Servicio de Medicina Maternofetal, BCNatal-Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic de Barcelona y Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Sociedad Española de Ginecología y Obstetricia, Barcelona, Spain
| | - Irene Rivero Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario de Santiago de Compostela, Sociedad Española de Infectología Pediátrica (SEIP), Grupo Genética, Vacunas, Infecciones y Pediatría (GENVIP). Asociación Española de Pediatría (CAV-AEP), Santiago de Compostela, A Coruña, Spain
| | - Anna Suy Franch
- Sección de Obstetricia, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Sociedad Española de Ginecología y Obstetricia, Barcelona, Spain
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Sun G, Wang G, Zhong H. Observational analysis of the immunogenicity and safety of various types of spinal muscular atrophy vaccines. Inflammopharmacology 2024; 32:1025-1038. [PMID: 38308795 DOI: 10.1007/s10787-023-01395-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/14/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND This study aimed to evaluate the immunogenicity and safety of different types of poliovirus vaccines. METHODS A randomized, blinded, single-center, parallel-controlled design was employed, and 360 infants aged ≥ 2 months were selected as study subjects. They were randomly assigned to bOPV group (oral Sabin vaccine) and sIPV group (Sabin strain inactivated polio vaccine), with 180 infants in each group. Adverse reaction events in the vaccinated subjects were recorded. The micro-neutralization test using cell culture was conducted to determine the geometric mean titer (GMT) of neutralizing antibodies against poliovirus types I, II, and III in different groups, and the seroconversion rates were calculated. RESULTS Both groups exhibited a 100% seropositivity rate after booster immunization. The titers of neutralizing antibodies for the three types were predominantly distributed within the range of 1:128 to 1:512. The fold increase of type I antibodies differed markedly between the two groups (P < 0.05). Moreover, the fold increase of type II and type III antibodies for poliovirus differed slightly between the two groups (P > 0.05). The fourfold increase rate in sIPV group was drastically superior to that in bOPV group (P < 0.05). When comparing the post-immunization GMT levels of type I antibodies in individuals who completed the full course of spinal muscular atrophy vaccination, bOPV group showed greatly inferior levels to sIPV group (P < 0.05). For type II and type III antibodies, individuals in bOPV group demonstrated drastically superior post-immunization GMT levels to those in sIPV group (P < 0.05). The incidence of adverse reactions between the bOPV and sIPV groups differed slightly (P > 0.05). CONCLUSION These findings indicated that both the oral vaccine and inactivated vaccine had good safety and immunogenicity in infants aged ≥ 2 months. The sIPV group generated higher levels of neutralizing antibodies in serum, particularly evident in the post-immunization GMT levels for types II and III.
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Affiliation(s)
- Guojuan Sun
- Immunization Program Department, Daqing Center for Disease Control and Prevention, Daqing, 163000, Heilongjiang, China
| | - Guangzhi Wang
- Pathology Department, Daqing People's Hospital, Daqing, 163000, Heilongjiang, China
| | - Heng Zhong
- Endocrinology Department, Heilongjiang Provincial Hospital, Harbin, 150036, Heilongjiang, China.
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Gastesi Orbegozo I, Cea-Soriano L, Llorente A, Huerta-Álvarez C. Lack of association between COVID-19 vaccines and miscarriage onset using a case-crossover design. Sci Rep 2024; 14:7275. [PMID: 38538736 PMCID: PMC10973422 DOI: 10.1038/s41598-024-57880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024] Open
Abstract
Pregnant women might have an increased risk of SARS-COV-2 infection. Although evidence towards the efficacy and safety of COVID-19 is growing still there is room for improvement on the knowledge towards pregnancy adverse events, such as miscarriage. We explored the association of COVID-19 vaccine with the risk of miscarriages using the Real-World. We identified a cohort of vaccinated pregnancies using the BIFAP database which contains systematically recorded data on care patients in Spain (N = 4054). We then restricted it to those women who had a miscarriage using a validated algorithm (N = 607). Among them, we performed a case-crossover design to evaluate the effect of intermittent exposures on the risk of miscarriage. Adjusted Odds Ratio with their confidence intervals were calculated using two analytical approaches: conditional logistic regression and Generalized Linear Mixed-Effects Models. A total of 225 (37.1%) were aged 35-39 years. The most common comorbidities were asthma, migraine, gastritis, and hypothyroidism. A total of 14.7% received only one dose of COVID-19 and 85.3% two doses, respectively. A total of 36.8% of women with one dose and 27.6% with two doses received the vaccine 7 days prior to the miscarriage. Corresponding adjusted estimates for the risk of miscarriage using the conditional logistic regression where as follows: 1.65 (95% CI 0.85-3.23) when using as the sum of 3 control moments among women with one dose, 1.02 (95% CI 0.72-1.46) among women with two doses and 1.03 (95% CI 0.72, 1.46) using the whole study population. Very similar results were obtained when conducting the Generalized Linear Mixed-Effects Models. There was no overall increased risk of miscarriage onset associated with COVID-19 vaccine although contradictory results were found according to the number of doses. Further studies are required with larger sample sizes to assess this association.
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Affiliation(s)
- Irati Gastesi Orbegozo
- Biomedical Research Foundation Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal Child Health, Faculty of Medicine, Complutense University of Madrid, Pza. Ramón y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain.
| | - Ana Llorente
- BIFAP, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices (AEMPS), Madrid, Spain
| | - Consuelo Huerta-Álvarez
- Department of Public Health and Maternal Child Health, Faculty of Medicine, Complutense University of Madrid, Pza. Ramón y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
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Nakabembe E, Cooper J, Amaral K, Tusubira V, Hsia Y, Abu-Raya B, Sekikubo M, Nakimuli A, Sadarangani M, Le Doare K. The safety and immunogenicity of vaccines administered to pregnant women living with HIV: a systematic review and meta-analysis. EClinicalMedicine 2024; 69:102448. [PMID: 38333366 PMCID: PMC10850112 DOI: 10.1016/j.eclinm.2024.102448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
Background Human Immunodeficiency Virus (HIV)-exposed uninfected (HEU) infants have a higher burden of infectious diseases related morbidity and mortality compared with HIV-unexposed uninfected (HUU). Immunization of pregnant women living with HIV (PWLWH) could reduce the severity and burden of infectious diseases for HEU in early infancy. Methods We conducted a systematic review of safety and immunogenicity of vaccines administered to PWLWH and meta-analyses to test the overall effect of immunogenicity comparing pregnant women without HIV (PWWH) to PWLWH. We searched MEDLINE, Embase, Web of Science, Virtual Health Library and Cochrane databases in accordance with PRISMA guidelines for randomized controlled trials and observational studies. Review articles, case series, conference abstracts, and animal studies were excluded. Studies were included from inception to 6th September 2023, with no language restrictions. Random effects meta-analyses were performed for immunogenicity using Review manager (RevMan) analysis software version 5.4.1, Geometric Mean Titer (GMT) values were transformed to obtain the mean and standard deviation within RevMan, the effect size was computed and reported as mean difference with respective 95% confidence intervals. The review was registered with PROSPERO CRD42021289081. Findings We included 12 articles, comprising 3744 pregnant women, 1714 were PWLWH given either influenza, pneumococcal or an investigational Group B streptococcal (GBS) vaccine. Five studies described safety outcomes, and no increase in adverse events was reported in PWLWH compared to PWWH. The GMT increase from baseline to 28-35 weeks post vaccination in HA units ranged from 12.4 (95% CI: 9.84-14.9) to 238.8 (95% CI: 0.35-477.9). Meta-analyses of influenza vaccines showed the pooled geometric mean difference in Hemagglutination Inhibition (HAI) titers post vaccination was 56.01 (95% CI: 45.01-67.01), p < 0.001. The increase was less in PWLWH when compared with PWWH: -141.76 (95% CI: -194.96, -88.55), p < 0.001. Interpretation There are limited data on the safety and immunogenicity of vaccines given to PWLWH making policy consideration in this group difficult when new vaccines are introduced. With new vaccines on the horizon, PWLWH need to be included in studies to promote vaccine confidence for this special population. Funding This work was funded by Medical Research Council Joint Clinical Trials Round 9 [MR/T004983/1].
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Affiliation(s)
- Eve Nakabembe
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Upper Mulago Hill Road, P.O. Box 7072, Kampala, Uganda
- Centre for Neonatal and Pediatric Infection, St George’s University of London, Cranmer Terrace, London SW170RE, United Kingdom
| | - Jo Cooper
- Centre for Neonatal and Pediatric Infection, St George’s University of London, Cranmer Terrace, London SW170RE, United Kingdom
| | - Kyle Amaral
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Valerie Tusubira
- Makerere University-Johns Hopkins Research Collaboration, Upper Mulago Hill Road, P.O. Box 23491, Kampala, Uganda
| | - Yingfen Hsia
- Centre for Neonatal and Pediatric Infection, St George’s University of London, Cranmer Terrace, London SW170RE, United Kingdom
| | - Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
| | - Musa Sekikubo
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Upper Mulago Hill Road, P.O. Box 7072, Kampala, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Upper Mulago Hill Road, P.O. Box 7072, Kampala, Uganda
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
| | - Kirsty Le Doare
- Centre for Neonatal and Pediatric Infection, St George’s University of London, Cranmer Terrace, London SW170RE, United Kingdom
- Makerere University-Johns Hopkins Research Collaboration, Upper Mulago Hill Road, P.O. Box 23491, Kampala, Uganda
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Pereira KHNP, Fuchs KDM, Mendonça JC, Xavier GM, Knupp FC, Lourenço MLG. Topics on maternal, fetal and neonatal immunology of dogs and cats. Vet Immunol Immunopathol 2023; 266:110678. [PMID: 38016336 DOI: 10.1016/j.vetimm.2023.110678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
Birth and the first few weeks of age are critical periods of developing the immune system of puppies and kittens and adapting to an environment containing a variety of infectious agents. The survival rate during these periods depends mainly on the newborn's immune capacity to prevent and combat infections. Although most components of innate and adaptive immunity are present at birth, responses are slow and immature compared to adults. Due to immunological immaturity and the endotheliochorial placental structure, circulating concentrations of immunoglobulins in dogs and cats at birth are quite low. Thus, newborns need a prompt and immediate immune response, which is essentially provided by defense cells and maternal antibodies via colostrum. Failure to ingest colostrum is correlated with high mortality rates in the neonatal period. Concurrently, factors related to pregnant, such as pregnancy physiological immunosuppression and nutritional and health states, can directly influence newborn immunity and health. Therefore, understanding the maternal and neonatal immunological aspects, importance of colostrum, risk factors for failure to transfer passive immunity and colostrum substitute strategies are essential to ensure the survival of the litter.
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Affiliation(s)
- Keylla Helena Nobre Pacífico Pereira
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Kárita da Mata Fuchs
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Júlia Cosenza Mendonça
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Gleice Mendes Xavier
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Fabíola Cardoso Knupp
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Maria Lucia Gomes Lourenço
- Veterinary Neonatology Research Group, Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
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Amaral E, Money D, Jamieson D, Pasupathy D, Aronoff D, Jacobsson B, Lizcano EIO. Vaccination during pregnancy: A golden opportunity to embrace. Int J Gynaecol Obstet 2023; 163:476-483. [PMID: 37417315 DOI: 10.1002/ijgo.14981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Immunization strategies are part of routine pregnancy care to prevent infectious diseases in the mother, the fetus, and the newborn. Maternal immunization recommendations followed the recognition of the consequences of infectious diseases in pregnancy, including vertical transmission and perinatal consequences. The recent COVID-19 pandemic highlighted the issue of vaccination among pregnant individuals. Recommendations vary globally; however, Tdap, influenza, and, recently, COVID-19 vaccines are routinely recommended during pregnancy. There are several new maternal immunization products in the pipeline, including those directed against malaria, cytomegalovirus, Group B Streptococcus, herpes simplex virus, and respiratory syncytial virus. Important challenges must be addressed in all countries to guarantee that pregnant individuals and their babies receive the best care possible, including uptake of recommended immunizations by their entire target population groups. These challenges include disseminating appropriate data for vaccine recommendations and many others, such as ensuring stakeholder endorsement, achieving in-country distribution and administration, adequate vaccine supply, and a well-organized healthcare system, ideally offering the immunization free of charge. More recently, the hesitancy of pregnant women to receive immunizations highlights the relevance of cultural aspects and other contextual factors affecting vaccine uptake among pregnant individuals.
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Affiliation(s)
- Eliana Amaral
- Department of Obstetrics & Gynecology, University of Campinas, São Paulo, Brazil
| | - Deborah Money
- Department of Obstetrics & Gynecology, University of Vancouver, Vancouver, British Columbia, Canada
| | - Denise Jamieson
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dharmintra Pasupathy
- Department of Maternal & Fetal Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - David Aronoff
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Bo Jacobsson
- Department of Obstetrics & Gynecology, University of Gothenburg, Gothenburg, Sweden
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de Bruin O, Phijffer E, Ahmadizar F, van der Maas N, Wildenbeest J, Sturkenboom M, Bont L, Bloemenkamp K. Are maternal vaccines effective and safe for mothers and infants? A systematic review and meta-analysis of randomised controlled trials. BMJ Glob Health 2023; 8:e012376. [PMID: 37899087 PMCID: PMC10619060 DOI: 10.1136/bmjgh-2023-012376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/16/2023] [Indexed: 10/31/2023] Open
Abstract
INTRODUCTION Maternal vaccination is a promising strategy to reduce the burden of vaccine-preventable diseases for mothers and infants. We aimed to provide an up-to-date overview of the efficacy and safety of all available maternal vaccines. METHODS We searched PubMed, Embase, CENTRAL and ClinicalTrials.gov on 1 February 2022, for phase III and IV randomised controlled trials (RCTs) that compared maternal vaccination against any pathogen with placebo or no vaccination. Primary outcomes were laboratory-confirmed or clinically confirmed disease in mothers and infants. Secondary safety outcomes included intrauterine growth restriction, stillbirth, maternal death, preterm birth, congenital malformations and infant death. Random effects meta-analysis were used to calculate pooled risk ratio's (RR). Quality appraisal was performed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS Six RCTs on four maternal vaccines, influenza, tetanus, diphtheria and pertussis (Tdap), pneumococcal and respiratory syncytial virus (RSV) were eligible. The overall risk of bias and certainty of evidence varied from low to high. Maternal influenza vaccination significantly reduced the number of laboratory-confirmed influenza cases (RR 0.58, 95% CI 0.42 to 0.79, event rate 57 vs 98, 2 RCTs, n=6003, I2=0%), and clinically confirmed influenza cases in mothers (RR 0.88, 95% CI 0.78 to 0.99, event rate 418 vs 472, 2 RCTs, n=6003, I2=0%), and laboratory-confirmed influenza in infants (RR 0.66, 95% CI 0.52 to 0.85, event rate 98 vs 148, 2 RCTs, n=5883, I2=0%), although this was not significant for clinically confirmed influenza in infants (RR 0.99, 95% CI 0.94 to 1.05, event rate 1371 vs 1378, 2 RCTs, n=5883, I2=0%). No efficacy data were available on maternal Tdap vaccination. Maternal pneumococcal vaccination did not reduce laboratory-confirmed and clinically confirmed middle ear disease (RR 0.49, 95% CI 0.24 to 1.02, event rate 9 vs 18, 1 RCT, n=133 and RR 0.88 95% CI 0.69 to 1.12, event rate 42 vs 47, 1 RCT, n=133, respectively), and clinically confirmed lower-respiratory tract infection (LRTI) (RR 1.08, 95% CI 0.82 to 1.43, event rate 18 vs 34, 1 RCT, n=70) in infants. Maternal RSV vaccination did not reduce laboratory-confirmed RSV LRTI in infants (RR 0.75, 95% CI 0.56 to 1.01, event rate 103 vs 71, 1 RCT, n=4527). There was no evidence of a significant effect of any of the maternal vaccines on the reported safety outcomes. CONCLUSIONS The few RCTs with low event rates suggest that, depending on the type of maternal vaccine, the vaccine might effectively prevent disease and within its size does not show safety concerns in mothers and infants. PROSPERO REGISTRATION NUMBER CRD42021235115.
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Affiliation(s)
- Odette de Bruin
- Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Emily Phijffer
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Fariba Ahmadizar
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicoline van der Maas
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Joanne Wildenbeest
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Miriam Sturkenboom
- Department of Datascience and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Louis Bont
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kitty Bloemenkamp
- Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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11
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Nyawanda BO, Opere VA, Nyiro JU, Vodicka E, Fleming JA, Baral R, Khan S, Pecenka C, Ayugi JO, Atito R, Ougo J, Bigogo G, Emukule GO, Otieno NA, Munywoki PK. Respiratory Syncytial Virus (RSV) Disease and Prevention Products: Knowledge, Attitudes, and Preferences of Kenyan Healthcare Workers in Two Counties in 2021. Vaccines (Basel) 2023; 11:1055. [PMID: 37376444 DOI: 10.3390/vaccines11061055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection (LRTI) among infants under 6 months of age. Yet, in Kenya, little is known about healthcare workers' (HCWs) knowledge, attitudes, and perceptions around RSV disease and the prevention products under development. Between September and October 2021, we conducted a mixed methods cross-sectional survey to assess HCWs' knowledge, attitudes, and perceptions of RSV disease and RSV vaccinations in two counties. We enrolled HCWs delivering services directly at maternal and child health (MCH) departments in selected health facilities (frontline HCWs) and health management officers (HMOs). Of the 106 respondents, 94 (88.7%) were frontline HCWs, while 12 were HMOs. Two of the HMOs were members of the Kenya National Immunization Technical Advisory Group (KENITAG). Of the 104 non-KENITAG HCWs, only 41 (39.4%) had heard about RSV disease, and 38/41 (92.7%) felt that pregnant women should be vaccinated against RSV. Most participants would recommend a single-dose vaccine schedule (n = 62, 58.5%) for maximal adherence and compliance (n = 38/62, 61.3%), single dose/device vaccines (n = 50/86, 58.1%) to prevent wastage and contamination, and maternal vaccination through antenatal care clinics (n = 53, 50%). We found the need for increased knowledge about RSV disease and prevention among Kenyan HCWs.
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Affiliation(s)
- Bryan O Nyawanda
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Victor A Opere
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Joyce U Nyiro
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi P.O. Box 230-80108, Kenya
| | - Elisabeth Vodicka
- Program for Appropriate Technology in Health-PATH, Seattle, WA 98121, USA
| | - Jessica A Fleming
- Program for Appropriate Technology in Health-PATH, Seattle, WA 98121, USA
| | - Ranju Baral
- Program for Appropriate Technology in Health-PATH, Seattle, WA 98121, USA
| | - Sadaf Khan
- Program for Appropriate Technology in Health-PATH, Seattle, WA 98121, USA
| | - Clint Pecenka
- Program for Appropriate Technology in Health-PATH, Seattle, WA 98121, USA
| | - Jorim O Ayugi
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Raphael Atito
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - James Ougo
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Godfrey Bigogo
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Gideon O Emukule
- US Centers for Disease Control and Prevention, Nairobi P.O. Box 606-00621, Kenya
| | - Nancy A Otieno
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Patrick K Munywoki
- US Centers for Disease Control and Prevention, Nairobi P.O. Box 606-00621, Kenya
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Heeralall C, Ibrahim UH, Lazarus L, Gathiram P, Mackraj I. The effects of COVID-19 on placental morphology. Placenta 2023; 138:88-96. [PMID: 37235921 DOI: 10.1016/j.placenta.2023.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/10/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
The impact of the COVID-19 infection, caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during the pandemic has been considerably more severe in pregnant women than non-pregnant women. Therefore, a review detailing the morphological alterations and physiological changes associated with COVID-19 during pregnancy and the effect that these changes have on the feto-placental unit is of high priority. This knowledge is crucial for these mothers, their babies and clinicians to ensure a healthy life post-pandemic. Hence, we review the placental morphological changes due to COVID-19 to enhance the general understanding of how pregnant mothers, their placentas and unborn children may have been affected by this pandemic. Based on current literature, we deduced that COVID-19 pregnancies were oxygen deficient, which could further result in other pregnancy-related complications like preeclampsia and IUGR. Therefore, we present an up-to-date review of the COVID-19 pathophysiological implications on the placenta, covering the function of the placenta in COVID-19, the effects of this virus on the placenta, its functions and its link to other gestational complications. Furthermore, we highlight the possible effects of COVID-19 therapeutic interventions on pregnant mothers and their unborn children. Based on the literature, we strongly suggest that consistent surveillance for the mothers and infants from COVID-19 pregnancies be prioritised in the future. Though the pandemic is now in the past, its effects are long-term, necessitating the monitoring of clinical manifestations in the near future.
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Affiliation(s)
- C Heeralall
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - U H Ibrahim
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - L Lazarus
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - P Gathiram
- Discipline of Family Medicine, School of Public Health and Nursing, University of KwaZulu-Natal, Durban, South Africa
| | - I Mackraj
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
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13
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Rimmer MP, Teh JJ, Mackenzie SC, Al Wattar BH. The risk of miscarriage following COVID-19 vaccination: a systematic review and meta-analysis. Hum Reprod 2023; 38:840-852. [PMID: 36794918 PMCID: PMC10152171 DOI: 10.1093/humrep/dead036] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
STUDY QUESTION What is the risk of miscarriage among pregnant women who received any of the COVID-19 vaccines? SUMMARY ANSWER There is no evidence that COVID-19 vaccines are associated with an increased risk of miscarriage. WHAT IS KNOWN ALREADY In response to the COVID-19 pandemic, the mass roll-out of vaccines helped to boost herd immunity and reduced hospital admissions, morbidity, and mortality. Still, many were concerned about the safety of vaccines for pregnancy, which may have limited their uptake among pregnant women and those planning a pregnancy. STUDY DESIGN, SIZE, DURATION For this systematic review and meta-analysis, we searched MEDLINE, EMBASE, and Cochrane CENTRAL from inception until June 2022 using a combination of keywords and MeSH terms. PARTICIPANTS/MATERIALS, SETTING, METHODS We included observational and interventional studies that enrolled pregnant women and evaluated any of the available COVID-19 vaccines compared to placebo or no vaccination. We primarily reported on miscarriage in addition to ongoing pregnancy and/or live birth. MAIN RESULTS AND THE ROLE OF CHANCE We included data from 21 studies (5 randomized trials and 16 observational studies) reporting on 149 685 women. The pooled rate of miscarriage among women who received a COVID-19 vaccine was 9% (n = 14 749/123 185, 95% CI 0.05-0.14). Compared to those who received a placebo or no vaccination, women who received a COVID-19 vaccine did not have a higher risk of miscarriage (risk ratio (RR) 1.07, 95% CI 0.89-1.28, I2 35.8%) and had comparable rates for ongoing pregnancy or live birth (RR 1.00, 95% CI 0.97-1.03, I2 10.72%). LIMITATIONS, REASONS FOR CAUTION Our analysis was limited to observational evidence with varied reporting, high heterogeneity and risk of bias across included studies, which may limit the generalizability and confidence in our findings. WIDER IMPLICATIONS OF THE FINDINGS COVID-19 vaccines are not associated with an increase in the risk of miscarriage or reduced rates of ongoing pregnancy or live birth among women of reproductive age. The current evidence remains limited and larger population studies are needed to further evaluate the effectiveness and safety of COVID-19 vaccination in pregnancy. STUDY FUNDING/COMPETING INTEREST(S) No direct funding was provided to support this work. M.P.R. was funded by the Medical Research Council Centre for Reproductive Health Grant No: MR/N022556/1. B.H.A.W. hold a personal development award from the National Institute of Health Research in the UK. All authors declare no conflict of interest. REGISTRATION NUMBER CRD42021289098.
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Affiliation(s)
- Michael P Rimmer
- Medical Research Council Centre for Reproductive Health, Institute of Regeneration and Repair, Edinburgh BioQuarter, University of Edinburgh, UK
| | - Jhia J Teh
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Scott C Mackenzie
- Medical Research Council Centre for Reproductive Health, Institute of Regeneration and Repair, Edinburgh BioQuarter, University of Edinburgh, UK
| | - Bassel H Al Wattar
- Beginnings Assisted Conception Unit, Epson and St Helier University Hospitals, London, UK
- Comprehensive Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, UK
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14
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Sanders B, Davis M. Effects of Climate Change and Air Pollution on Perinatal Health. J Midwifery Womens Health 2023; 68:383-390. [PMID: 37254462 DOI: 10.1111/jmwh.13522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Climate change is often framed as an environmental concern; however, the burning of fossil fuels both directly and indirectly impacts air quality and, thus, human health. Gas byproducts of combustion lead to increased levels of atmospheric ozone and carbon dioxide, which in turn elevate surface temperatures of the earth. This process exposes individuals to respiratory irritants and contributes to increased frequency of natural disasters such as wildfires, negatively impacting respiratory health. Normal physiologic changes in the respiratory system make pregnant people particularly vulnerable to the effects of air pollution. Asthma and allergic rhinitis are 2 common respiratory diseases that can be triggered by poor air quality. Solutions to limit the impact of climate change on respiratory disease include risk mitigation and reduction of fossil fuel consumption on individual, organization, and community levels. Midwives are well positioned as clinicians to educate people about individual strategies to reduce environmental exposure to respiratory irritants and advocate for policy changes to limit future health effects of climate change.
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Affiliation(s)
- Bethany Sanders
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Melissa Davis
- Vanderbilt University School of Nursing, Nashville, Tennessee
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15
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Zhuo Y, Li X, He Z, Lu M. Pathological mechanisms of neuroimmune response and multitarget disease-modifying therapies of mesenchymal stem cells in Parkinson's disease. Stem Cell Res Ther 2023; 14:80. [PMID: 37041580 PMCID: PMC10091615 DOI: 10.1186/s13287-023-03280-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/13/2023] [Indexed: 04/13/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disease characterized by the degeneration of dopaminergic neurons in the substantia nigra (SN); the etiology and pathological mechanism of the disease are still unclear. Recent studies have shown that the activation of a neuroimmune response plays a key role in the development of PD. Alpha-synuclein (α-Syn), the primary pathological marker of PD, can gather in the SN and trigger a neuroinflammatory response by activating microglia which can further activate the dopaminergic neuron's neuroimmune response mediated by reactive T cells through antigen presentation. It has been shown that adaptive immunity and antigen presentation processes are involved in the process of PD and further research on the neuroimmune response mechanism may open new methods for its prevention and therapy. While current therapeutic regimens are still focused on controlling clinical symptoms, applications such as immunoregulatory strategies can delay the symptoms and the process of neurodegeneration. In this review, we summarized the progression of the neuroimmune response in PD based on recent studies and focused on the use of mesenchymal stem cell (MSC) therapy and challenges as a strategy of disease-modifying therapy with multiple targets.
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Affiliation(s)
- Yi Zhuo
- Department of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410000, Hunan, China
- The National and Local Joint Engineering Laboratory of Animal Peptide Drug Development, College of Life Sciences, Hunan Normal University, Changsha, 410006, Hunan, China
| | - Xuan Li
- Department of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410000, Hunan, China
| | - Zhengwen He
- Department of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410000, Hunan, China.
| | - Ming Lu
- The National and Local Joint Engineering Laboratory of Animal Peptide Drug Development, College of Life Sciences, Hunan Normal University, Changsha, 410006, Hunan, China.
- Hunan Provincial Key Laboratory of Neurorestoratology, The Second Affiliated Hospital (the 921st Hospital of PLA), Hunan Normal University, Changsha, 410003, Hunan, China.
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16
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Sookaromdee P, Wiwanitkit V. Monkeypox in the Pregnant Woman and Obstetric Problem. J Obstet Gynaecol India 2023; 73:194. [PMID: 37073236 PMCID: PMC10105797 DOI: 10.1007/s13224-022-01694-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/12/2022] [Indexed: 10/14/2022] Open
Affiliation(s)
| | - Viroj Wiwanitkit
- Joseph Ayobabalola University, Ikeji-Arakeji, Nigeria
- Dr. DY Patil University, Pune, India
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17
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Herdea V, Tarciuc P, Ghionaru R, Pana B, Chirila S, Varga A, Mărginean CO, Diaconescu S, Leibovitz E. A Sensitive Public Health Issue—The Vaccine Acceptancy and the Anti-Pertussis Immune Status of Pregnant Women from a Romanian Metropolitan Area. CHILDREN 2023; 10:children10040640. [PMID: 37189889 DOI: 10.3390/children10040640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
(1) Background: Immunization of pregnant women (PWs) against Bordetella pertussis infection is still a challenging health matter. (2) Methods: We gathered questionnaire data from 180 PWs regarding their expectancies and current opinion on infectious disease prevention. For the group of PWs who agreed to further investigations, the serum levels of Ig G anti-B. pertussis antibodies (IgG-PT) titer were measured and analyzed. (3) Results: A total of 180 PWs completed the questionnaire and 98 (54.44%, study group) accepted to perform the laboratory tests. During the first two pregnancy trimesters, PWs were found to be more willing (compared with the control group) to test for identifying high-risk situations that could affect themselves and their future infant (p < 0.001). Most of the participating PWs (91, 91.9%) had low levels of anti-pertussis antibodies (values < 40 IU/mL). Declared vaccine coverage of the PWs newborn infants for DTaP-1 and Prevenar 13 (at 2 months) and DTaP-2 and Prevenar 13 (at 4 months) vaccination reached 100% in the study group, while in the control group only 30/82 (36.59%) PWs accepted to be vaccinated during pregnancy, none of them providing data on their infants’ vaccine coverage. (4) Conclusions: Enrolled PWs faced a waning immunity against the B. pertussis infection. By raising maternal confidence in the protective role of vaccines against infectious diseases, better vaccine acceptance and better infant vaccine coverage can be achieved.
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18
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Sookaromdee P, Wiwanitkit V. Neonate, infected mother and monkeypox: the present concern. J Perinat Med 2023; 51:437. [PMID: 35933578 DOI: 10.1515/jpm-2022-0256] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/29/2022] [Indexed: 01/21/2023]
Affiliation(s)
| | - Viroj Wiwanitkit
- Joseph Ayobabalola University, Ikeji-Arakeji, Nigeria.,Dr DY Patil University, Pune, India
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19
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Restivo V, Fallucca A, Trapani F, Immordino P, Calamusa G, Casuccio A. Measles Immunization Status of Health Care Workers: A Cross-Sectional Study Exploring Factors Associated with Lack of Immunization According to the Health Belief Model. Vaccines (Basel) 2023; 11:vaccines11030618. [PMID: 36992202 DOI: 10.3390/vaccines11030618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Suboptimal levels of measles vaccination coverage make Italy a country where the circulation of the virus is still endemic. In the past decade, several nosocomial outbreaks of measles occurred in Italy that rapidly spread the infection among large numbers of hospitalized patients and susceptible healthcare workers (HCWs). A cross-sectional study was conducted at the University Hospital of Palermo (Italy) to estimate the rate of HCWs immunization and to investigate the factors associated with lack of immunization. The attitude to the immunization practice was evaluated by exploring the Health Belief Model. Overall, 118 HCWs were enrolled, with a mean age of 31 years and 59.3% male. About half of the sample (45.8%, n = 54) was found not to be immunized against measles. Multivariable analysis showed that the factors directly associated with the non-immunization status against measles were female sex (OR = 3.70, p = 0.056), being an HCW different from a physician (OR = 10.27, p = 0.015), having a high perception of barriers to vaccination (OR = 5.13, p = 0.047), not being immunized for other exanthematous diseases such as chickenpox (OR = 9.93, p = 0.003), mumps (OR = 33.64, p < 0.001) and rubella (OR = 10.12, p= 0.002). There is a need to contrast the low adherence of HCWs to measles vaccination by identifying effective strategies to increase immunization coverage and limiting the risk of further nosocomial measles outbreaks.
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Affiliation(s)
- Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alessandra Fallucca
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Federica Trapani
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Palmira Immordino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Giuseppe Calamusa
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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20
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Namazova-Baranova LS, Fedoseenko MV, Selimzyanova LR, Kaliuzhnaia TA, Shakhtakhtinskaya FC, Tolstova SV, Selvyan AM. Modern Approaches in Immunoprophylaxis of Infectious Diseases During Pregnancy. PEDIATRIC PHARMACOLOGY 2023. [DOI: 10.15690/pf.v19i5.2487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Every year more countries recommend vaccination for pregnant women. Nowadays, the spectrum of vaccines that can be used during pregnancy is expanding. Experts of the Union of Pediatricians of Russia have completely updated the section about the pregnant women immunoprophylaxis within updating clinical guidelines on normal pregnancy management. This section is presented in the following article.
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Affiliation(s)
- Leyla S. Namazova-Baranova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Marina V. Fedoseenko
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Liliya R. Selimzyanova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Tatiana A. Kaliuzhnaia
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Firuza Ch. Shakhtakhtinskaya
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Svetlana V. Tolstova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery
| | - Arevaluis M. Selvyan
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery
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21
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Santacruz-Sanmartin E, Hincapié-Palacio D, Ochoa-Acosta JE, Buitrago-Giraldo S, Ospina MC. Measles Serostatus in Mothers and Their Newborns in Antioquia, Colombia: Implications for Measles Elimination. Am J Trop Med Hyg 2023; 108:93-100. [PMID: 36509051 PMCID: PMC9833067 DOI: 10.4269/ajtmh.22-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022] Open
Abstract
To describe the serostatus of measles IgG antibodies in pregnant women and newborns, placental transfer, and factors that determine being below the threshold of 150 mIU/mL, a cross-sectional study was conducted. Blood samples of 790 pregnant women at the time of delivery and 734 umbilical cord samples were analyzed from eight hospitals in the Aburrá Valley of Antioquia, Colombia. Measles IgG antibody measurement was performed with ELISA. The proportion of individuals with antibodies < 150 mIU/mL was 13.9% (95% CI: 12.2-15.8) in pregnant women and 11.1% (95% CI: 9.2-13.4) in newborns. The geometric mean of the antibody level of the pregnant women was 552 mIU/mL (95% CI: 504-605) and in the umbilical cord 662 mIU/mL (95% CI: 604-727). A positive correlation between pregnant woman and umbilical cord antibodies was found. The median ratio of measles IgG antibodies in umbilical cord/pregnant woman was 1.22 for all participants. A seroprevalence below the threshold of 150 mIU/mL was found in newborns whose mothers were born between 1983 and 1994, compared with those born before that period, when exposure to the wildtype virus was common (adjusted prevalence ratio: 3.6, 95% CI: 1.3-9.6). These findings suggest that there are gaps in measles immunity among women of childbearing age, before pregnancy. To close this immune gap and support efforts to maintain measles control, serological screening for measles antibodies should be routinely included in reproductive health and antenatal care programs to identify women without immunity who should be vaccinated before pregnancy or after delivery.
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Affiliation(s)
| | | | - Jesús E. Ochoa-Acosta
- “Héctor Abad Gómez” National Faculty of Public Health, Universidad of Antioquia, Medellin, Colombia
| | - Seti Buitrago-Giraldo
- Departmental Laboratory of Public Health, The Sectional Secretariat of Health and Social Protection of Antioquia, Medellin, Colombia
| | - Marta C. Ospina
- Departmental Laboratory of Public Health, The Sectional Secretariat of Health and Social Protection of Antioquia, Medellin, Colombia
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22
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Mpox and pregnancy: A neglected disease and its impact on perinatal health. Rev Clin Esp 2023; 223:32-39. [PMID: 36341988 PMCID: PMC9620439 DOI: 10.1016/j.rceng.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
Viral infections during pregnancy have been one of the leading causes associated with significant perinatal problems, such as congenital defects, fetal neurological syndromes, stillbirths, and adverse pregnancy outcomes. The mpox virus infection, caused by an Orthopoxvirus related to the human smallpox virus, was declared a global health emergency by the World Health Organization in July 2022 due to the large number of cases emerging outside the usual endemic area in Africa. There is little information on the impact of mpox virus infection during pregnancy, although the limited evidence available shows a high rate of fetal harm. This review addresses the problem of mpox virus infection in pregnant women and provides indications for its prevention, diagnosis, and treatment.
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23
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Velázquez-Cervantes MA, Ulloa-Aguilar JM, León-Juárez M. [Mpox and pregnancy: A neglected disease and its impact on perinatal health]. Rev Clin Esp 2023; 223:32-39. [PMID: 36277866 PMCID: PMC9576805 DOI: 10.1016/j.rce.2022.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
Viral infections during pregnancy have been one of the leading causes associated with significant perinatal problems, such as congenital defects, fetal neurological syndromes, stillbirths, and adverse pregnancy outcomes. The mpox virus infection, caused by an Orthopoxvirus related to the human smallpox virus, was declared a global health emergency by the World Health Organization in July 2022 due to the large number of cases emerging outside the usual endemic area in Africa. There is little information on the impact of mpox virus infection during pregnancy, although the limited evidence available shows a high rate of fetal harm. This review addresses the problem of mpox virus infection in pregnant women and provides indications for its prevention, diagnosis, and treatment.
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Affiliation(s)
- M A Velázquez-Cervantes
- Departamento de Inmuno-bioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - J M Ulloa-Aguilar
- Departamento de Inmuno-bioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - M León-Juárez
- Departamento de Inmuno-bioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
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24
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Dousti R, Allahqoli L, Ayar Kocaturk A, Hakimi S. Can human papillomavirus vaccination during pregnancy result in miscarriage and stillbirth? A meta-analysis and systematic review. Eur J Midwifery 2023; 7:9. [PMID: 37128190 PMCID: PMC10148262 DOI: 10.18332/ejm/161793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/27/2023] [Accepted: 03/20/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION Contradictory results regarding the safety of human papillomavirus (HPV) vaccination during pregnancy have been obtained, which has cast doubt on the use of this method. This review and meta-analysis were conducted to evaluate the safety of HPV vaccination during pregnancy. METHODS Complying with the inclusion and exclusion criteria, we searched Web of Science, Scopus, Medline, EMBASE, PubMed and Google Scholar databases for articles published in the past decade using the following keywords: 'papilloma human virus', 'HPV vaccine', 'pregnancy' and 'safety and prevention'. The minimum report quality of the articles was 16 based on the STROBE checklist. RESULTS Seven articles were included in the study, three of which were included in the meta-analysis, and the rest were reviewed systematically. The results of the meta-analysis showed that vaccination against HPV during pregnancy or around this period does not increase the risk of miscarriage (RR=2.01; 95% CI: 0.66-6.13) and stillbirth (RR=2.02: 95% CI: 0.65-6.27). No significant difference between miscarriage and stillbirth was observed in women vaccinated against HPV versus those not vaccinated. CONCLUSIONS The study of 1380424 individuals showed that HPV vaccination during pregnancy is better postponed until after this period. However, no significant evidence was found to indicate that vaccination was dangerous and unsafe during pregnancy. Further studies are needed to draw a more definitive conclusion.
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Affiliation(s)
- Rana Dousti
- Faculty of Nursing and Midwifery, Tabriz University of Medical Science, Tabriz, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Sevil Hakimi
- Faculty of Nursing and Midwifery, Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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25
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Du T, Qu Q, Zhang Y, Huang Q. No observable influence of COVID-19 inactivated vaccines on pregnancy and birth outcomes in the first trimester of gestation. Expert Rev Vaccines 2023; 22:900-905. [PMID: 37843409 DOI: 10.1080/14760584.2023.2271084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/11/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND While studies have demonstrated that certain COVID-19 vaccines administered during pregnancy did not affect neonatal or maternal outcomes significantly, the safety of inactivated SARS-CoV-2 vaccines in China, given during the first trimester, remains to be fully elucidated. METHOD A retrospective cohort study was conducted involving female participants who gave birth from January to October 2021. The study compared pregnancy, delivery, and neonatal outcomes between subjects who received one or two doses of the inactivated COVID-19 vaccines during their first trimester and unvaccinated control subjects. RESULTS A total of 2658 pregnant women was recruited. Among them, 2358 (88.7%) reported ongoing pregnancies; 326 (13.8%) of these were vaccinated. Additionally, 277 (10.4%) experienced spontaneous miscarriages between 6 to 20 gestational weeks; 40 (14.4%) of these were vaccinated, yielding an odds ratio of 0.67-1.36 (95% confidence interval) for COVID-19 vaccination. The comparison of neonatal complications, including an Apgar score less than 7, preterm birth, low birth weight, and newborn respiratory complications, between unvaccinated and vaccinated participants revealed no statistical significance. CONCLUSION The administration of COVID-19 inactivated vaccines during the first trimester of pregnancy is not associated with adverse pregnancy or neonatal outcomes, providing a substantial ground for pertinent health education.
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Affiliation(s)
- Ting Du
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Qiuxia Qu
- Clinical Immunology Institute, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yawen Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Qin Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
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26
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Chimukuche RS, Nkosi B, Seeley J. Policy and Guideline Review of Vaccine Safety for COVID-19 in Pregnant Women in Southern Africa, with a Particular Focus on South Africa. Vaccines (Basel) 2022; 10:vaccines10122077. [PMID: 36560487 PMCID: PMC9786044 DOI: 10.3390/vaccines10122077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Pregnant and lactating mothers have historically been excluded from clinical trials. To understand the shift from excluding to including this population in COVID-19 vaccine trials, we conducted a review of guidance issued by countries in southern Africa over the last three years. We conducted a review of documents and official statements recorded on Ministries of Health websites, and social media platforms, the World Health Organisation website, the COVID-19 Maternal Immunisation tracker and the African Union official webpage. Search terms included COVID-19 vaccination policies, guidelines for pregnant and lactating women, COVID-19 vaccination trials and pregnant women. We retrieved and reviewed policies, guidelines, and official statements from 12 countries. We found inconsistencies and incomplete guidance in respect to the inclusion of pregnant and lactating mothers in COVID-19 vaccine trials from the selected countries. Of the twelve countries reviewed, Namibia and South Africa had clear guidance on vaccination plans and implementation for pregnant women, and their inclusion in COVID-19 vaccine trials. Explicit and clear guidelines are critical in communicating changes in policy towards those deemed vulnerable for them to participate in vaccine trials. This review provides lessons for future pandemics on managing changes in guidance towards those groups historically excluded from vaccine and clinical trials.
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Affiliation(s)
- Rujeko Samanthia Chimukuche
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infection & Immunity, University College London, London WC1E 6BT, UK
- Correspondence:
| | - Busisiwe Nkosi
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal, KwaZulu-Natal, South Africa
- Department of Global Health and Development, London School of Tropical Hygiene and Medicine, London WC1H 9SH, UK
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Cao M, Wu Y, Lin Y, Xu Z, Liang Z, Huang Q, Li S, Liu H, An C, Luo Y, Liu H, Liu J. Inactivated Covid-19 vaccine did not undermine live birth and neonatal outcomes of women with frozen-thawed embryo transfer. Hum Reprod 2022; 37:2942-2951. [PMID: 36200874 PMCID: PMC9619751 DOI: 10.1093/humrep/deac220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/16/2022] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Does inoculation with inactivated vaccines against coronavirus disease 2019 (Covid-19) before frozen-thawed embryo transfer (FET) affect live birth and neonatal outcomes? SUMMARY ANSWER Inactivated Covid-19 vaccines did not undermine live birth and neonatal outcomes of women planning for FET. WHAT IS KNOWN ALREADY Accumulating reports are now available indicating the safe use of mRNA vaccines against Covid-19 in pregnant and lactating women, and a few reports indicate that they are not associated with adverse effects on ovarian stimulation or early pregnancy outcomes following IVF. Evidence about the safety of inactivated Covid-19 vaccines is very limited. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort analysis from Reproductive Medical Center of a tertiary teaching hospital. Clinical records and vaccination record of 2574 couples with embryos transferred between 1 March 2021 and 30 September 2021 were screened for eligibility of this study. PARTICIPANTS/MATERIALS, SETTING, METHODS Clinical and vaccination data of infertile couples planning for FET were screened for eligibility of the study. The reproductive and neonatal outcomes of FET women inoculated with inactivated Covid-19 vaccines or not were compared. The primary outcomes were live birth rate per embryo transfer cycle and newborns' birth height and weight. Secondary outcomes included rates of ongoing pregnancy, clinical pregnancy, biochemical pregnancy and spontaneous miscarriage. Multivariate logistical regression and propensity score matching (PSM) analyses were performed to minimize the influence of confounding factors. Subgroup analyses, including single dose versus double dose of the vaccines and the time intervals between the first vaccination and embryo transfer, were also performed. MAIN RESULTS AND THE ROLE OF CHANCE Vaccinated women have comparable live birth rates (43.6% versus 45.0% before PSM, P = 0.590; and 42.9% versus 43.9% after PSM, P = 0.688), ongoing pregnancy rates (48.2% versus 48.1% before PSM, P = 0.980; and 52.2% versus 52.7% after PSM, P = 0.875) and clinical pregnancy rate (55.0% versus 54.8% before PSM, P = 0.928; and 54.7% versus 54.2% after PSM, P = 0.868) when compared with unvaccinated counterparts. The newborns' birth length (50.0 ± 1.6 versus 49.0 ± 2.9 cm before PSM, P = 0.116; and 49.9 ± 1.7 versus 49.3 ± 2.6 cm after PSM, P = 0.141) and birth weight (3111.2 ± 349.9 versus 3030.3 ± 588.5 g before PSM, P = 0.544; and 3053.8 ± 372.5 versus 3039.2 ± 496.8 g after PSM, P = 0.347) were all similar between the two groups. Neither single dose nor double dose of vaccines, as well as different intervals between vaccination and embryo transfer showed any significant impacts on reproductive and neonatal outcomes. LIMITATIONS, REASONS FOR CAUTION The main findings might be limited by retrospective design. Besides, inoculations of triple dose of Covid-19 vaccines were not available by the time of data collection, thus the results cannot reflect the safe use of triple dose of inactivated Covid-19 vaccines. Finally, history of Covid-19 infection was based on patients' self-report rather than objective laboratory tests. WIDER IMPLICATIONS OF THE FINDINGS Eligible individuals of inactivated vaccines against Covid-19 should not postpone vaccination plan because of their embryo transfer schedule, or vice versa. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Medical Key Discipline of Guangzhou (2021-2023). All authors had nothing to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | | | | | - Zijin Xu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhu Liang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qing Huang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sichen Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hanyan Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyan An
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yiqun Luo
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haiying Liu
- Correspondence address. E-mail: (J.L.); E-mail: (H.L.)
| | - Jianqiao Liu
- Correspondence address. E-mail: (J.L.); E-mail: (H.L.)
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28
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Charde SH, Warbhe RA. Human Papillomavirus Prevention by Vaccination: A Review Article. Cureus 2022; 14:e30037. [DOI: 10.7759/cureus.30037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
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29
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Chutiyami M, Salihu D, Bello UM, Winser SJ, Gambo AA, Sabo H, Kolo AM, Jalo HA, Muhammad AS, Mahmud FA, Adeleye KK, Azubuike OM, Bukola IM, Kannan P. Are Fear of COVID-19 and Vaccine Hesitancy Associated with COVID-19 Vaccine Uptake? A Population-Based Online Survey in Nigeria. Vaccines (Basel) 2022; 10:vaccines10081271. [PMID: 36016160 PMCID: PMC9415607 DOI: 10.3390/vaccines10081271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
This study examined the association between COVID-19 and fear of contracting COVID-19 and reasons for vaccination refusal. A population-based online survey was conducted via social media in Nigeria using the Fear of COVID-19 scale and items related to vaccination refusal/hesitancy items. Individuals aged 13 years and older were invited to participate. Data were analysed using binary logistic regression to calculate odds ratios (ORs) and associated 95% confidence intervals (CIs) at a p-value of less than 0.05. The study enrolled 577 individuals with a mean age of 31.86 years, 70% of whom were male and 27.7% of whom had received at least one dose of the vaccine against COVID-19. None of the variables on the Fear of COVID-19 scale significantly predicted vaccine uptake in multivariate analysis. However, individuals who were fearful of COVID-19 were more likely to be vaccinated in bivariate analysis (OR: 1.7, 95% CI: 1.06–2.63). The most significant factors among the vaccination refusal items associated with COVID-19 vaccination were doubts about vaccination (adjusted OR: 2.56, 95% CI: 1.57–4.17) and misconceptions about vaccine safety/efficacy (adjusted OR: 2.15, 95% CI: 1.24–3.71). These results suggest that uptake of the vaccine against COVID-19 in Nigeria can be predicted by factors associated with vaccination refusal, but not by fear of COVID-19. To contain the pandemic COVID-19 in Nigeria, efforts should be made to educate people about the efficacy of the vaccine and to increase their confidence in vaccination.
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Affiliation(s)
- Muhammad Chutiyami
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia
| | - Dauda Salihu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- College of Nursing, Jouf University, Sakaka 42421, Saudi Arabia
| | - Umar Muhammad Bello
- Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
- Correspondence: (U.M.B.); (S.J.W.)
| | - Stanley John Winser
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Correspondence: (U.M.B.); (S.J.W.)
| | - Amina Abdullahi Gambo
- Department of Paediatrics, Aminu Kano Teaching Hospital (AKTH), Kano 700101, Nigeria
| | - Hadiza Sabo
- School of Basic Midwifery, Shehu Sule College of Nursing and Midwifery Damaturu, Damaturu 100101, Nigeria
| | - Adam Mustapha Kolo
- Family Health International (FHI 360) Borno State, Maiduguri 600215, Nigeria
| | | | | | - Fatima Ado Mahmud
- Physiotherapy Department, Yobe State Specialist Hospital, Damaturu 620241, Nigeria
| | | | | | | | - Priya Kannan
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong 999077, China
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30
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Lee KMN, Junkins EJ, Luo C, Fatima UA, Cox ML, Clancy KBH. Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination. SCIENCE ADVANCES 2022; 8:eabm7201. [PMID: 35857495 PMCID: PMC9286513 DOI: 10.1126/sciadv.abm7201] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Early in 2021, many people began sharing that they experienced unexpected menstrual bleeding after SARS-CoV-2 inoculation. We investigated this emerging phenomenon of changed menstrual bleeding patterns among a convenience sample of currently and formerly menstruating people using a web-based survey. In this sample, 42% of people with regular menstrual cycles bled more heavily than usual, while 44% reported no change after being vaccinated. Among respondents who typically do not menstruate, 71% of people on long-acting reversible contraceptives, 39% of people on gender-affirming hormones, and 66% of postmenopausal people reported breakthrough bleeding. We found that increased/breakthrough bleeding was significantly associated with age, systemic vaccine side effects (fever and/or fatigue), history of pregnancy or birth, and ethnicity. Generally, changes to menstrual bleeding are not uncommon or dangerous, yet attention to these experiences is necessary to build trust in medicine.
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Affiliation(s)
- Katharine M. N. Lee
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Department of Anthropology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
| | - Eleanor J. Junkins
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Chongliang Luo
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Urooba A. Fatima
- Department of Anthropology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Maria L. Cox
- Program in Ecology, Evolution, and Conservation, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Kathryn B. H. Clancy
- Department of Anthropology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Program in Ecology, Evolution, and Conservation, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Corresponding author.
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31
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Gangi R, Corrias A, Pintus R, Marcialis MA, Fanos V. What to Expect from COVID-19 and from COVID-19 Vaccine for Expecting or Lactating Women. Pediatr Rep 2022; 14:262-275. [PMID: 35736656 PMCID: PMC9228525 DOI: 10.3390/pediatric14020034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 12/21/2022] Open
Abstract
Recent studies identified pregnancy as a high-risk condition for the development of maternal-fetal complications in the case of the SARS-CoV-2 infection. Therefore, the scientific community is now considering pregnant women a "fragile" category that should be vaccinated with high priority. The number of pregnant women undergoing hospitalization since summer 2021, including Intensive Care Unit admission, is growing, as well as the risk of preterm birth. Evidence from both animals and humans suggest that, similarly to other vaccines routinely administered in pregnancy, COVID-19 vaccines are not crossing the placenta, do not increase the risk of miscarriage, preterm birth, stillbirth, the birth of small gestational age neonates, as well as the risk of congenital abnormalities. To date, the World Health Organization and scientific literature are promoting and encouraging the vaccination of all pregnant and lactating women. The aim of our narrative review is to present the available literature regarding this issue with the aim to provide appropriate answers to the most frequent requests, doubts, and fears that have led many expecting and lactating women not to become vaccinated during this pandemic period.
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Affiliation(s)
- Roberta Gangi
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Angelica Corrias
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Roberta Pintus
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
- Correspondence:
| | - Maria Antonietta Marcialis
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
| | - Vassilios Fanos
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
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Rodríguez-Díaz M, Alonso-Molero J, Cabero-Perez MJ, Llorca J, Dierssen-Sotos T, Gómez-Acebo I. Pregnancy and Birth Outcomes during the Early Months of the COVID-19 Pandemic: The MOACC-19 Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10931. [PMID: 34682679 PMCID: PMC8535818 DOI: 10.3390/ijerph182010931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/29/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023]
Abstract
The new coronavirus, SARS-CoV-2, is devastating for specific groups of patients, but currently there is not enough information concerning its effects on pregnant women. The purpose of this study is to identify the impact of SARS-CoV-2 infection on pregnancy and the consequences that it could cause. We studied a cohort of pregnant ladies who were tested for SARS-CoV-2 infection by RT-PCR and classified as infected or not infected. The recruitment was carried out in the HUMV hospital, a third-level hospital located in Santander, northern Spain. It started on 23 March 2020 and ended on 14 October 2020. Data from our cohort were compared to another cohort recruited in 2018 at the same hospital. We found that gestational hypertension, placental abruptio, and home exposure to an infected person, among other variables, could be associated with SARS-CoV-2 infection. In conclusion, we consider pregnant women a high-risk group of patients towards a possible SARS-CoV-2 infection, especially those who present with conditions such as gestational hypertension or obesity; moreover, we think that SARS-CoV-2 infection could increase the possibilities of having an abruptio placentae, although this result was found in only a few women, so it requires further confirmation.
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Affiliation(s)
- Marta Rodríguez-Díaz
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
| | - Jéssica Alonso-Molero
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
- IDIVAL Instituto de Investigación Sanitaria Valdecilla, 39011 Santander, Spain
| | - María J. Cabero-Perez
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
- IDIVAL Instituto de Investigación Sanitaria Valdecilla, 39011 Santander, Spain
- Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - Javier Llorca
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Trinidad Dierssen-Sotos
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
- IDIVAL Instituto de Investigación Sanitaria Valdecilla, 39011 Santander, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Inés Gómez-Acebo
- Faculty of Medicine, Universidad de Cantabria, 39011 Santander, Spain; (M.R.-D.); (J.A.-M.); (M.J.C.-P.); (J.L.)
- IDIVAL Instituto de Investigación Sanitaria Valdecilla, 39011 Santander, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Dad N, Buhmaid S, Mulik V. Vaccination in pregnancy - The when, what and how? Eur J Obstet Gynecol Reprod Biol 2021; 265:1-6. [PMID: 34403876 DOI: 10.1016/j.ejogrb.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 01/07/2023]
Abstract
Immunization is a fundamental component of preventive healthcare. This gain special significance in pregnancy. Maternal antigen-specific IgG, is actively transported across the placenta during pregnancy. This significantly, contributes to infant immunity in the first few months of life. Vaccination during pregnancy has the potential to indirectly protect the most vulnerable infants during the first few months of life, when vaccine responses are generally poor and it is difficult to achieve rapid protection through immunization. This is especially relevant when there is prior exposure to infection in woman or vaccine administration. A vaccine given during pregnancy in these women would result in a booster response and a relatively high level of IgG protecting their children in initial few months of life. Passive antibody transfer from mother to fetus can protect fetuses from infection until their own immunization schedule is initiated. Lack of administration of appropriate vaccination to women during pregnancy lead to an increase in maternal and fetal morbidity and mortality from preventable infections like influenza, pertussis. Various preventable infections can lead to intensive care unit admission for mothers, preterm birth, and low birth weight babies. Recent covid pandemic has brought issue of vaccine use in pregnancy at forefront of all expectant mothers. Immunization with inactivated virus, bacterial vaccine and toxoids showed no evidence of adverse fetal effects. As a rule, live attenuated vaccines are not recommended in pregnancy. This paper gives snapshot of all vaccines, which can be used in pregnancy along with brief details regards various bacterial and viral infections , their common clinical features and effects on pregnancy outcome as well as fetus. This is will provide a useful guide for healthcare providers.
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Affiliation(s)
- Nimra Dad
- Sidra Medicine, PO Box 26999, Education city, Doha, Qatar
| | - Sara Buhmaid
- Sidra Medicine, PO Box 26999, Education city, Doha, Qatar
| | - Varsha Mulik
- Sidra Medicine, PO Box 26999, Education city, Doha, Qatar.
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Wang PH, Lee WL, Yang ST, Tsui KH, Chang CC, Lee FK. The impact of COVID-19 in pregnancy: Part II. Vaccination to pregnant women. J Chin Med Assoc 2021; 84:903-910. [PMID: 34433191 DOI: 10.1097/jcma.0000000000000612] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Effective strategies are urgently needed to decrease the risk of untoward outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) infection. Pregnant women are a vulnerable population to infectious disease pandemics with dramatically increased infectious diseases-related serious complications, such as the need of hospitalizations, the need of admission to intensive care unit, and the final disease-related death compared with those nonpregnant counterparts or those pregnant women without infection. Several studies have shown that vaccinations in pregnancy are a safe and highly effective strategy, not only for pregnant women but also for fetus and/or newborn because of the passive transplacental transfer of antibodies to the offspring. Active and passive prevention of infectious diseases is approved as effective strategies for women who attempt to become pregnant or during pregnancy. Despite the large and proven scientific evidence, pregnant women still puzzle over whether they should get vaccinated. The question therefore arises: Why are pregnant women so reluctant to receive vaccination? The explanation is more likely in the way that the benefits of vaccination have been communicated "confusedly." In fact, like virtually all clinical trials, all the COVID-19 vaccine trials have excluded pregnant and lactating women from participating, contributing to uncertainty of safety and efficacy in COVID-19 vaccines that have been well prepared and available for the general adult population worldwide. Moreover, messenger RNA vaccine is a relatively brand-new vaccine, and experience with this type of vaccine is still scarce. It is hard to overcome this innovation deadlock. The knowledge and awareness of pregnant women who are at risk, and full information on the knowledge of vaccines and related preventable diseases in pregnant women may avoid hesitancy and increase vaccine acceptance. The current review is a part two addressing the impact of COVID-19 on pregnant women. We focus on the up-to-date information about the application of vaccination on pregnant women, especially during this COVID-19 pandemic.
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Affiliation(s)
- Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
| | - Szu-Ting Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kuan-Hao Tsui
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC
- Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan, ROC
| | - Cheng-Chang Chang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Fa-Kung Lee
- Department of Obstetrics and Gynecology, Cathy General Hospital, Taipei, Taiwan, ROC
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Dąbek J, Sierka O, Kulik H, Gąsior Z. Protective vaccinations during pregnancy - adult Poles knowledge in this area. BMC Public Health 2021; 21:1392. [PMID: 34256706 PMCID: PMC8276846 DOI: 10.1186/s12889-021-11336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The vaccine is a preparation of biological origin containing antigens that stimulate the body's immune system to produce acquired immunity. Vaccines can contain killed or "live" (attenuated) microorganisms as well as fragments of these (antigens). Although many vaccines are used routinely in pregnancy to provide a seroprotective immune response for mother, fetus and neonate there is much controversy over their use during this unique time. The aim of the study was to find out about the knowledge of adult Poles on the use of preventive vaccinations during pregnancy. METHODS The study involved 700 people (100%) aged 18 to 80 years ([Formula: see text] = 32.16 ± 16.46). Most of the respondents were women (511; 73%). The study consisted of 9 questions about preventive vaccinations of pregnant women and 5 questions about members of the studied group. The aforementioned questions formed the basis of the preparation of the presented article. RESULTS A significant part of respondents (322; 46%) did not have knowledge on the topic of safeness of using preventive vaccinations during pregnancy, 196 (28%) respondents believed that such procedure is not safe. Most of the respondents (371; 53%) did not know about the possibility of using "live" vaccines during pregnancy. 14 (2%) of respondents believed that pregnancy should be terminated in case of administration of a "live" vaccine to a pregnant woman. According to 294 (42%) respondents, vaccinations with "live" vaccines should be completed at least 3 months before the planned pregnancy. The subjects were not aware of the issue of post-exposure vaccination against tetanus and rabies among pregnant women. The respondents' responses were divided on the issue of the safest trimester of pregnancy for vaccine administration. Almost 1/3 of the respondents (203; 29%) indicated the third trimester as the safest for their performance. CONCLUSION The knowledge of the surveyed group, the majority of whom were women, about the use of vaccinations before and during pregnancy was unsatisfactory. There is a need to educate the public about the benefits and risks of performing or avoiding preventive vaccinations during pregnancy.
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Affiliation(s)
- Józefa Dąbek
- Department of Cardiology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Ziołowa street 45/47, 40-635, Katowice, Poland
| | - Oskar Sierka
- Student Research Group at the Department of Cardiology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Ziołowa street 45/47, 40-635, Katowice, Poland.
| | - Halina Kulik
- Department of Propaedeutics of Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Francuska street 20/24, 40-027, Katowice, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Ziołowa street 45/47, 40-635, Katowice, Poland
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Jahn B, Sroczynski G, Bicher M, Rippinger C, Mühlberger N, Santamaria J, Urach C, Schomaker M, Stojkov I, Schmid D, Weiss G, Wiedermann U, Redlberger-Fritz M, Druml C, Kretzschmar M, Paulke-Korinek M, Ostermann H, Czasch C, Endel G, Bock W, Popper N, Siebert U. Targeted COVID-19 Vaccination (TAV-COVID) Considering Limited Vaccination Capacities-An Agent-Based Modeling Evaluation. Vaccines (Basel) 2021; 9:434. [PMID: 33925650 PMCID: PMC8145290 DOI: 10.3390/vaccines9050434] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/21/2022] Open
Abstract
(1) Background: The Austrian supply of COVID-19 vaccine is limited for now. We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria. (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 ≥ years), middle aged (45-64 years), younger (15-44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW). First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed deriving a prioritization sequence for 2.45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination. We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness. (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations. Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety. (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available.
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Affiliation(s)
- Beate Jahn
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
| | - Gaby Sroczynski
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
| | - Martin Bicher
- dwh GmbH, dwh Simulation Services, Neustiftgasse 57–59, A-1070 Vienna, Austria; (M.B.); (C.R.); (C.U.); (N.P.)
- Institute of Information Systems Engineering, TU Wien, Favoritenstraße 11, A-1050 Vienna, Austria
| | - Claire Rippinger
- dwh GmbH, dwh Simulation Services, Neustiftgasse 57–59, A-1070 Vienna, Austria; (M.B.); (C.R.); (C.U.); (N.P.)
| | - Nikolai Mühlberger
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
| | - Júlia Santamaria
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
| | - Christoph Urach
- dwh GmbH, dwh Simulation Services, Neustiftgasse 57–59, A-1070 Vienna, Austria; (M.B.); (C.R.); (C.U.); (N.P.)
| | - Michael Schomaker
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
- Center for Infectious Disease Epidemiology and Research, University of Cape Town, Barnard Fuller Building, Anzio Rd, Observatory, Cape Town 7935, South Africa
| | - Igor Stojkov
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
| | - Daniela Schmid
- Division for Quantitative Methods in Public Health and Health Services Research, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria;
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Ursula Wiedermann
- Center of Pathophysiology, Infectiology & Immunology (OEL), Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria;
| | - Monika Redlberger-Fritz
- Center of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria;
| | - Christiane Druml
- UNESCO Chair on Bioethics, Medical University of Vienna, Waehringerstrasse 25, 1090 Vienna, Austria;
| | - Mirjam Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands;
| | - Maria Paulke-Korinek
- Ministry of Social Affairs, Health, Care and Consumer Protection, Stubenring 1, 1010 Vienna, Austria;
| | - Herwig Ostermann
- Austrian National Public Health Institute/Gesundheit Österreich GmbH, Stubenring 6, 1010 Vienna, Austria; (H.O.); (C.C.)
| | - Caroline Czasch
- Austrian National Public Health Institute/Gesundheit Österreich GmbH, Stubenring 6, 1010 Vienna, Austria; (H.O.); (C.C.)
| | - Gottfried Endel
- Austrian Federation of Social Insurances, Kundmanngasse 21, 1030 Vienna, Austria;
| | - Wolfgang Bock
- Department of Mathematics, TU Kaiserslautern, Gottlieb-Daimler-Straße 48, 67663 Kaiserslautern, Germany;
| | - Nikolas Popper
- dwh GmbH, dwh Simulation Services, Neustiftgasse 57–59, A-1070 Vienna, Austria; (M.B.); (C.R.); (C.U.); (N.P.)
- Institute of Information Systems Engineering, TU Wien, Favoritenstraße 11, A-1050 Vienna, Austria
- Association for Decision Support for Health Policy and Planning, DEXHELPP, Neustiftgasse 57–59, A-1070 Vienna, Austria
| | - Uwe Siebert
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria; (B.J.); (G.S.); (N.M.); (J.S.); (M.S.); (I.S.)
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 101 Merrimac St., Boston, MA 02114, USA
- Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA 02115, USA
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