1
|
Fernández-García S, Del Campo-Albendea L, Sambamoorthi D, Sheikh J, Lau K, Osei-Lah N, Ramkumar A, Naidu H, Stoney N, Sundaram P, Sengupta P, Mehta S, Attarde S, Maddock S, Manning M, Meherally Z, Ansari K, Lawson H, Yap M, Kew T, Punnoose A, Knight C, Sadeqa E, Cherian J, Ravi S, Chen W, Walker K, O'Donoghue K, van Wely M, van Leeuwen E, Kostova E, Kunst H, Khalil A, Brizuela V, Kara E, Kim CR, Thorson A, Oladapo OT, Mofenson L, Gottlieb SL, Bonet M, Moss N, Zamora J, Allotey J, Thangaratinam S. Effectiveness and safety of COVID-19 vaccines on maternal and perinatal outcomes: a systematic review and meta-analysis. BMJ Glob Health 2024; 9:e014247. [PMID: 38580375 PMCID: PMC11002410 DOI: 10.1136/bmjgh-2023-014247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/26/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes. DESIGN Systematic review and meta-analysis. DATA SOURCES Major databases between December 2019 and January 2023. STUDY SELECTION Nine pairs of reviewers contributed to study selection. We included test-negative designs, comparative cohorts and randomised trials on effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Non-comparative cohort studies reporting reactogenicity outcomes were also included. QUALITY ASSESSMENT, DATA EXTRACTION AND ANALYSIS Two reviewers independently assessed study quality and extracted data. We undertook random-effects meta-analysis and reported findings as HRs, risk ratios (RRs), ORs or rates with 95% CIs. RESULTS Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women). CONCLUSION COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women. PROSPERO REGISTRATION NUMBER CRD42020178076.
Collapse
Affiliation(s)
- Silvia Fernández-García
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Laura Del Campo-Albendea
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBERESP, Madrid, Spain
| | | | - Jameela Sheikh
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Karen Lau
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Nana Osei-Lah
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Anoushka Ramkumar
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Harshitha Naidu
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Nicole Stoney
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Paul Sundaram
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | - Samay Mehta
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Shruti Attarde
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Sophie Maddock
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Millie Manning
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | - Kehkashan Ansari
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Heidi Lawson
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Magnus Yap
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Tania Kew
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Andriya Punnoose
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Chloe Knight
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Eyna Sadeqa
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Jiya Cherian
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Sangamithra Ravi
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Wentin Chen
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | | | - Madelon van Wely
- Amsterdam UMC Location AMC Center for Reproductive Medicine, Amsterdam, The Netherlands
| | - Elizabeth van Leeuwen
- Amsterdam UMC Location AMC Department of Obstetrics Gynecology, Amsterdam, The Netherlands
| | - Elena Kostova
- Amsterdam UMC Location AMC Center for Reproductive Medicine, Amsterdam, The Netherlands
| | - Heinke Kunst
- Queen Mary University of London Blizard Institute, London, UK
- Barts Health NHS Trust, London, UK
| | - Asma Khalil
- St George's University of London, London, UK
| | - Vanessa Brizuela
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Edna Kara
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Caron Rahn Kim
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Anna Thorson
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Olufemi T Oladapo
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Lynne Mofenson
- Research, Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA
| | - Sami L Gottlieb
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Mercedes Bonet
- Department of Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | | | - Javier Zamora
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBERESP, Madrid, Spain
- NIHR Birmingham Biomedical Centre (BRC), University Hospitals Birmingham, Birmingham, UK
| | - John Allotey
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Centre (BRC), University Hospitals Birmingham, Birmingham, UK
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Centre (BRC), University Hospitals Birmingham, Birmingham, UK
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
2
|
Sourouni M, Germeyer A, Feißt M, Balzer A, Köster H, Minte A, Brüggmann D, Kohll C, Reinhardt K, Möginger M, Leonhardt A, Banz-Jansen C, Bohlmann M, Fröhlich C, Backes C, Hager D, Kaup L, Hollatz-Galuschki E, Engelbrecht C, Markfeld-Erol F, Hagenbeck C, Schäffler H, Winkler J, Stubert J, Rathberger K, Lüber L, Hertlein L, Machill A, Richter M, Berghäuser M, Weigel M, Morgen M, Horn N, Jakubowski P, Riebe B, Ramsauer B, Sczesny R, Schäfer-Graf UM, Schrey S, Kehl S, Lastinger J, Seeger S, Parchmann O, Iannaccone A, Rohne J, Gattung L, Morfeld CA, Abou-Dakn M, Schmidt M, Glöckner M, Jebens A, Sondern KM, Pecks U, Schmitz R, Möllers M. Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS). Geburtshilfe Frauenheilkd 2023; 83:1508-1518. [PMID: 38046525 PMCID: PMC10689107 DOI: 10.1055/a-2196-6224] [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: 08/28/2023] [Accepted: 10/22/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19. Materials and Methods A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated. Results The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI > 30 kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome. Conclusion Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.
Collapse
Affiliation(s)
- Marina Sourouni
- Gynäkologische Endokrinologie und Fertilitätsstörungen, University Hospital Heidelberg, Heidelberg, Germany
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Ariane Germeyer
- Gynäkologische Endokrinologie und Fertilitätsstörungen, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuel Feißt
- Universitätsklinikum Heidelberg, Institut für Medizinische Biometrie, Heidelberg, Germany
| | - Alexandra Balzer
- Universitätsklinikum Heidelberg, Institut für Medizinische Biometrie, Heidelberg, Germany
| | | | - Annemarie Minte
- Department of Obstetrics and Gynecology, Cristophorus Hospital, Coesfeld, Germany
| | - Dörthe Brüggmann
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - Celine Kohll
- Gynäkologie und Geburtshilfe, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Kristin Reinhardt
- Geburtshilfe und Pränatalmedizin, Universitätsklinikum Halle, Halle, Germany
| | - Michaela Möginger
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Giessen und Marburg, Standort Marburg, Marburg, Germany
| | - Anja Leonhardt
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Constanze Banz-Jansen
- Gynäkologie und Geburtshilfe, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Germany
| | - Michael Bohlmann
- Zentrum für Gynäkologie und Geburtshilfe, St. Elisabethen-Krankenhaus Lörrach gGmbH, Lörrach, Germany
| | | | - Clara Backes
- Klinik für Gynäkologie und Geburtshilfe, Schön Hospital Munich Harlaching, München, Germany
| | - Dietrich Hager
- Klinik für Gynäkologie und Geburtshilfe, Thüringen-Kliniken Saalfeld-Rudolstadt, Thüringen, Germany
| | - Lisa Kaup
- Dr. Geisenhofer Clinic for Gynecology and Obstetrics, München, Germany
| | | | | | | | - Carsten Hagenbeck
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Hening Schäffler
- Klinik für Gynäkologie und Geburtshilfe, Ulm University Hospital, Ulm, Germany
| | - Jennifer Winkler
- Klinik und Poliklinik für Gynäkologie und Geburtshilfe, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Johannes Stubert
- Dept. of Gynecology and Obstetrics, University of Rostock, Rostock, Germany
| | - Katharina Rathberger
- Klinik für Frauenheilkunde und Geburtshilfe, Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Laura Lüber
- Klinik für Gynäkologie und Geburtshilfe, Oberschwaben Hospital Group, Ravensburg, Germany
| | - Linda Hertlein
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU, München, Germany
| | - Antonia Machill
- Department of Obstetrics and Gynecology, Vinzenz Pallotti Hospital, Bensberg, Germany
| | - Manuela Richter
- Neonatologie, Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - Martin Berghäuser
- Klinik für Kinderheilkunde, Florence-Nightingale-Krankenhaus, Düsseldorf, Germany
| | - Michael Weigel
- Frauenklinik, Leopoldina-Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Germany
| | - Mirjam Morgen
- Klinik für Gynäkologie und Geburtshilfe, St. Vincenz-Krankenhaus, Datteln, Germany
| | - Nora Horn
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Peter Jakubowski
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany
| | - Bastian Riebe
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Links der Weser gGmbH, Bremen, Germany
| | - Babett Ramsauer
- Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Robert Sczesny
- Klinik für Gynäkologie und Geburtshilfe, Marienhaus Hospital Saint Elisabeth Neuwied, Neuwied, Germany
| | | | - Susanne Schrey
- Abteilung für Geburtsmedizin, Uniklinik Leipzig, Leipzig, Germany
| | - Sven Kehl
- Gynecology & Obstetrics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Julia Lastinger
- Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Linz, Austria
| | - Sven Seeger
- Klinik für Geburtshilfe, Krankenhaus St. Elisabeth und St. Barbara Halle, Halle, Germany
| | - Olaf Parchmann
- Klinik für Gynäkologie und Geburtshilfe, HELIOS Hospital Sangerhausen, Sangerhausen, Germany
| | - Antonella Iannaccone
- Klinik für Gynäkologie und Geburtshilfe, University Hospital Essen, Essen, Germany
| | - Jens Rohne
- Klinik für Gynäkologie und Geburtshilfe, Maria Heimsuchung Caritas Klinik Pankow, Berlin, Germany
| | - Luise Gattung
- Klinik für Gynäkologie und Geburtshilfe, Bad Salzungen Hospital, Bad Salzungen, Germany
| | | | - Michael Abou-Dakn
- Klinik für Gynäkologie, St. Joseph Krankenhaus Berlin-Tempelhof, Berlin, Germany
| | - Markus Schmidt
- Gynecology & Obstetrics, Sana Kliniken Duisburg GmbH, Duisburg, Germany
| | - Michaela Glöckner
- Abteilung für Gynäkologie und Geburtshilfe, Hospital Memmingen, Memmingen, Germany
| | - Anja Jebens
- Abteilung für Gynäkologie und Geburtshilfe, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | | | | | - Ralf Schmitz
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Mareike Möllers
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| |
Collapse
|
3
|
Zöllkau J, Heimann Y, Hagenbeck C, Pecks U, Abou-Dakn M, Schlösser R, Schohe A, Dressler-Steinbach I, Manz M, Banz-Jansen C, Reuschel E, Iannaccone A, Bohlmann MK, Kraft K, Fill Malfertheiner S, Wimberger P, Kolben T, Bartmann C, Longardt AC. Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS). J Hum Lact 2023; 39:625-635. [PMID: 37712573 DOI: 10.1177/08903344231190623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic and its influence on peripartum processes worldwide led to issues in breastfeeding support. RESEARCH AIM The aim of this study was to describe breastfeeding behavior and peripartum in-hospital management during the pandemic in Germany and Austria. METHODS This study was a descriptive study using a combination of secondary longitudinal data and a cross-sectional online survey. Registry data from the prospective multicenter COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS) cohort study (longitudinal, medical records of 1,815 parent-neonate pairs with confirmed SARS-CoV-2 infection during pregnancy) and a cross-sectional online survey of CRONOS hospitals' physicians (N = 67) were used for a descriptive comparison of feeding outcomes and postpartum management. RESULTS In 93.7% (n = 1700) of the cases in which information on the neonate's diet was provided, feeding was with the mother's own milk. Among neonates not receiving their mother's own milk, 24.3% (n = 26) reported SARS-CoV-2 infection as the reason. Peripartum maternal SARS-CoV-2 infection, severe maternal COVID-19 including the need for intensive care unit (ICU) treatment or invasive ventilation, preterm birth, mandatory delivery due to COVID-19, and neonatal ICU admission were associated with lower rates of breastfeeding. Rooming-in positively influenced breastfeeding without affecting neonatal SARS-CoV-2 frequency (4.2% vs. 5.6%). CRONOS hospitals reported that feeding an infant their mother's own milk continued to be supported during the pandemic. In cases of severe COVID-19, four of five hospitals encouraged breastfeeding. CONCLUSION Maintaining rooming-in and breastfeeding support services in the CRONOS hospitals during the pandemic resulted in high breastfeeding rates.
Collapse
Affiliation(s)
- Janine Zöllkau
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Yvonne Heimann
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Michael Abou-Dakn
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | - Rolf Schlösser
- Hospital for Children and Adolescents, University Hospital of Frankfurt, Frankfurt, Germany
| | - Anna Schohe
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | | | - Maike Manz
- Department of Obstetrics and Gynecology, Darmstadt City Hospital, Darmstadt, Germany
| | - Constanze Banz-Jansen
- Department of Gynecology and Obstetrics, Protestant Hospital of Bethel Foundation, Bielefeld, Germany
| | - Edith Reuschel
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | | | - Michael K Bohlmann
- Department of Obstetrics and Gynecology, St. Elisabeth' Hospital, Loerrach, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, Munich Municipal Hospital, Harlaching, Munich, Germany
| | - Sara Fill Malfertheiner
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, TU Dresden, Dresden, Germany
| | - Thomas Kolben
- Department for Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Catharina Bartmann
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
| | - Ann - Carolin Longardt
- Clinic for Pediatrics and Adolescent Medicine I / Neonatology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| |
Collapse
|
4
|
da Silva Filho AO, Gonçalves DN, de Lima LKR, da Silva Alves DAN, de Andrade Falcão FJ, Falcão REA. Levels of Neutralizing Antibodies against SARS-CoV-2 in Mothers and Neonates after Vaccination during Pregnancy. Vaccines (Basel) 2023; 11:vaccines11030620. [PMID: 36992203 DOI: 10.3390/vaccines11030620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Maternal vaccination is safe and provides protection against COVID-19 in mothers and neonates, and it is necessary to evaluate its effect on the induction of immune responses through the levels of neutralizing antibodies present in maternal and neonatal blood. Methods: An observational study with transversal analysis was carried out. Included in the research were neonates (<1 month) whose mothers had been immunized whilst pregnant with at least one dose of the vaccine BNT16b and had not shown any symptoms of COVID-19. The blood of the mothers and newborns was collected during the Guthrie test and sent to the laboratory for the detection of neutralizing antibodies against SARS-CoV-2. Results: A total of 162 pairs of mothers and neonates were analyzed with an average age of 26.3 ± 5.97 years and 13.4 ± 6.90 days, respectively. All samples collected present neutralizing antibodies with an average percentage of 91% in the mothers and 92% in the neonates. The most satisfactory immune response was observed in neonates and mothers vaccinated during the second trimester of gestation. Conclusions: The vaccination of expectant mothers with the immunizer BNT162b2 has promoted a robust immunological response in both the mothers and the neonates.
Collapse
Affiliation(s)
- Antônio Oliveira da Silva Filho
- Post-Graduate Program in Health and Socio-Environmental Development Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
- Department of Health Sciences, Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| | - Daniel Nazário Gonçalves
- Department of Health Sciences, Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| | | | | | | | - Rosângela Estevão Alves Falcão
- Post-Graduate Program in Health and Socio-Environmental Development Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| |
Collapse
|
5
|
Konje JC, Al Beloushi M, Ahmed B. Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy. Viruses 2023; 15:v15030621. [PMID: 36992330 PMCID: PMC10059008 DOI: 10.3390/v15030621] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
Following reports of the first human SARS-CoV2 infection in December 2019 from Wuhan Province, China, there was such rapid spread that by March 2021, the World Health Organization (WHO) had declared a pandemic. Over 6.5 million people have died from this infection worldwide, although this is most likely an underestimate. Until vaccines became available, mortality and severe morbidity were costly in terms of life lost as well as the cost of supporting the severely and acutely ill. Vaccination changed the landscape, and following worldwide adoption, life has gradually been returning to normal. The speed of production of the vaccines was unprecedented and undoubtedly ushered in a new era in the science of fighting infections. The developed vaccines were on the already known platforms for vaccine delivery: inactivated virus, virus vector, virus-like particles (VLP) subunit, DNA and mRNA. The mRNA platform was used for the first time to deliver vaccines to humans. An understanding of these platforms and the pros and cons of each are important for clinicians who are often challenged by the recipients on the advantages and risks of these vaccines. These vaccines have so far and reassuringly been shown to be safe in reproduction (with no effect on gametes) and pregnancy (not associated with congenital malformations). However, safety remains paramount and continuing vigilance is critical, especially against rare fatal complications such as vaccine-induced thrombocytopenia and myocarditis. Finally, the waning immunity months after vaccination means repeated immunisation is likely to be ongoing, but just how often and how many such revaccinations should be recommended remains uncertain. Research into other vaccines and alternate delivery methods should continue as this infection is likely to be around for a long time.
Collapse
Affiliation(s)
- Justin C. Konje
- Feto-Maternal Centre Al Markhiya, Doha P.O. Box 34181, Qatar
- Obstetrics and Gynecology Department, Weill Cornell Medicine Qatar, Doha P.O. Box 24144, Qatar
- Obstetrics and Gynaecology, Department of Health Sciences, University of Leicester, Leicester LE2 7LX, UK
- Correspondence: ; Tel.: +974-7777-8375
| | - Mariam Al Beloushi
- Women’s Wellness and Research Centre, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
- Department of Obstetrics and Gynaecology, Qatar University, Doha P.O. Box 2713, Qatar
| | - Badreldeen Ahmed
- Feto-Maternal Centre Al Markhiya, Doha P.O. Box 34181, Qatar
- Obstetrics and Gynecology Department, Weill Cornell Medicine Qatar, Doha P.O. Box 24144, Qatar
- Department of Obstetrics and Gynaecology, Qatar University, Doha P.O. Box 2713, Qatar
| |
Collapse
|
6
|
Romero-Ibarguengoitia ME, Flores-Salazar ZL, Arroyo-García KD, Soto-Gámez R, Leal-Meléndez JA, René Garza-Herrera M, Bennett-Vidales G, Cabrera MH, González-Habib R, Jiménez LP, Garza-Bulnes R, Barco-Flores IA, Castillo-Figueroa LF, Garza-Silva A, Rivera-Cavazos A, Rivera-Salinas D, González-Cantú A, Sanz-Sánchez MÁ. Evaluation of Transplacental Antibody Transfer in Pregnant Women Immunized with Different SARS-CoV-2 Homologous or Heterologous Schemes. Vaccines (Basel) 2023; 11:vaccines11020415. [PMID: 36851294 PMCID: PMC9961240 DOI: 10.3390/vaccines11020415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
There is scarce information related to transplacental antibody transfer against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with different homologous and heterologous vaccination schemes. This study aimed to correlate the magnitude of transplacental transfer anti-SARS-CoV-2 antibodies in different homologous and heterologous schemes. An observational cross-sectional study was developed to identify pregnant women vaccinated against SARS-CoV-2. They were questioned about their immunization status; blood samples from the mother, umbilical cord during labor, and the newborn 72 h after birth were taken to measure anti-S1 and anti-S2 specific IgG antibodies for SARS-CoV-2. We recruited 104 women with a median age of 29 (SD 1.17). We found antibodies in all newborns with vaccinated mothers. Homologous BNT162b2 mRNA regimen had the highest mean (SD) antibody titers (AU/mL) in maternal (994.93 (3.08), p = 0.039), umbilical cord (1316.43 (2.79), p = 0.016), and newborn (1192.02 (3.55), p = 0.020) blood. The generalized linear model showed a positive effect over antibodies with at least one dose in maternal (β = -1.1, p = 0.002) and newborn (β= -0.717, p = 0.044) blood, and with two doses (β = -0.684, p = 0.026) in umbilical cord blood. In conclusion, antibodies were detected in all vaccinated women and their newborns. Transfer of antibodies was found from the first dose, and the levels increased with the number of vaccine doses. Vaccination should be encouraged in pregnant women with any available scheme.
Collapse
Affiliation(s)
- Maria Elena Romero-Ibarguengoitia
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Sistema de Salud, Calle Miguel Hidalgo y Costilla 2525, Obispado, Monterrey 64000, Nuevo León, Mexico
- Correspondence: ; Tel.: +52-81-8865-5656
| | - Zulema Lourdes Flores-Salazar
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Kimberly Dariela Arroyo-García
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Ginecología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Rafael Soto-Gámez
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Ginecología, Hospital Clínica Nova de Monterrey, Avenida del Bosque 139, Cuauhtémoc, Cuauhtémoc, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | | | | | - Gordon Bennett-Vidales
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Mauricio Hurtado Cabrera
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Roberto González-Habib
- Departamento de Ginecología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Liliann Peña Jiménez
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Raúl Garza-Bulnes
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | | | - Luis Fernando Castillo-Figueroa
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
- Departamento de Neonatología, Hospital Clínica Nova de Monterrey, Avenida del Bosque 139, Cuauhtémoc, Cuauhtémoc, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Arnulfo Garza-Silva
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Andrea Rivera-Cavazos
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Diego Rivera-Salinas
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Arnulfo González-Cantú
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Sistema de Salud, Calle Miguel Hidalgo y Costilla 2525, Obispado, Monterrey 64000, Nuevo León, Mexico
| | - Miguel Ángel Sanz-Sánchez
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| |
Collapse
|
7
|
Kentschke D, Bauer I, Moser J, Schleger F, Hahn M, Pauluschke-Fröhlich J, Jakubowski P, Abele H, Preissl H, Hartkopf J. COVID-19 and Perinatal Stress Experience - a Study Conducted as Part of the COVGEN Initiative. Geburtshilfe Frauenheilkd 2022; 82:1265-1273. [PMID: 36339634 PMCID: PMC9633229 DOI: 10.1055/a-1909-0451] [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: 03/22/2022] [Accepted: 07/25/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction During the COVID-19 pandemic, stress and anxiety in the population increased due to concerns about people's own health and that of their relatives, as well as changes in everyday life due to measures taken to reduce the infection rate. Pregnant women are particularly stressed. The present study examines how the COVID-19 pandemic affects the stress experience and mental health of pregnant women and mothers of newborns and how care could be optimized. Methods As part of the international COVGEN initiative ( https://www.covgen.org ) to investigate the effects of the COVID-19 pandemic on the peripartum period, pregnant and postpartum women were asked about their experience with stress using the COPE-IS (Coronavirus Perinatal Experiences - Impact Survey) questionnaire developed for this purpose and translated from the English. In addition, demographic data, pre-existing diseases, pregnancy complications and the care situation were recorded. The questionnaire was either administered as hardcopy to inpatients at the Department of Women's Health, University Hospital Tübingen, Germany, or online. All pregnant women and mothers who were pregnant or had given birth after the official start of the COVID-19 pandemic (11 March 2020) were eligible to participate. Results Complete data sets of n = 156 pregnant women and n = 221 postpartum women were available for evaluation. The general stress level assessed with the COPE-IS was significantly increased by the COVID-19 pandemic in both, pregnant and postpartum women, with pre-existing conditions such as respiratory diseases and pregnancy-related diseases like gestational diabetes adding to the stress. The subjectively perceived quality of care/support during pregnancy also influenced the stress level. Conclusions Fears of a COVID-19 infection and changes in preventive and aftercare services were a burden for the women surveyed. Intensified care during pregnancy and puerperium could help to stabilize the mental situation and reduce stress.
Collapse
Affiliation(s)
- Dominik Kentschke
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany
| | - Ilena Bauer
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany
| | - Julia Moser
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany
| | - Franziska Schleger
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany
| | - Marlene Hahn
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | | | - Peter Jakubowski
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Harald Abele
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany,Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Eberhard-Karls-University Tübingen, Tübingen,
Germany
| | - Julia Hartkopf
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD),
Tübingen, Germany,Korrespondenzadresse Dr. rer. nat. Julia Hartkopf University of Tübingen/fMEG Center; German Center for Diabetes Research (DZD), Institute for
Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center MunichOtfried-Mueller-Straße 4772076
TübingenGermany
| |
Collapse
|