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Aldecoa KAT, Arsene C, Krishnamoorthy G, Chng T, Cherry G, Chowdhury N, Clark R, Deeb D, Deptula L, Dietz G, Eto E, Golston V, Lawson L, Mbionwu C, Okponyia O, Orejuela J, Qipo T, Raut S, Goodman J. Risk and Protective Factors for COVID-19 Infection among Pregnant Women with Sickle Cell Trait. Adv Hematol 2024; 2024:1595091. [PMID: 38899005 PMCID: PMC11186680 DOI: 10.1155/2024/1595091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/30/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Pregnant women and individuals with sickle cell trait (SCT) and underlying comorbidities are both independently more vulnerable to severe illness from coronavirus disease 2019 (COVID-19) compared to nonpregnant women and those without SCT. However, our understanding of the specific factors influencing susceptibility to COVID-19 infection among pregnant women with SCT is currently constrained by limited available data. This study aims to determine the risk and protective factors that influence the likelihood of COVID-19 infection in this population. A retrospective analysis was done among 151 women with SCT in the reproductive age group. Multivariable analysis was performed to determine the various factors affecting COVID-19 infection among pregnant women with SCT. The study found that COVID-19-vaccinated pregnant women with SCT had a 90% lower risk of contracting COVID-19 and were 9 times more likely to have a COVID-19 infection if they had a history of pulmonary conditions such as asthma or chronic obstructive pulmonary disease. The present study further emphasizes the importance of the COVID-19 vaccine in preventing infection and safeguarding the health of pregnant women with SCT, particularly those with underlying comorbidities.
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Affiliation(s)
- Kim Abbegail Tan Aldecoa
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Camelia Arsene
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Geetha Krishnamoorthy
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Tiffany Chng
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Garrett Cherry
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Nabila Chowdhury
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Ryan Clark
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Dana Deeb
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Lisa Deptula
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Grey Dietz
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Ewomamobuho Eto
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Victoria Golston
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Landon Lawson
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Chioma Mbionwu
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Obiefuna Okponyia
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Detroit Wayne County Authority Health, Detroit, MI, USA
| | - Jennifer Orejuela
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Thomaidha Qipo
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Sumit Raut
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Judie Goodman
- Department of Hematology and Oncology, Trinity Health Oakland, Pontiac, MI, USA
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Patel A, Puglisi JL, Patel S, Tarn DM. COVID-19 Vaccine Acceptance in Pregnant Women in the United States: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2024; 33:453-466. [PMID: 38112561 DOI: 10.1089/jwh.2023.0498] [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: 12/21/2023] Open
Abstract
Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.
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Affiliation(s)
- Amy Patel
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Jose L Puglisi
- Department of Basic Science, College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Seeta Patel
- College of Letters and Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Derjung M Tarn
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Vanstone M, Correia RH, Howard M, Darling E, Bayrampour H, Carruthers A, Davis A, Hadid D, Hetherington E, Jones A, Kandasamy S, Kuyvenhoven C, Liauw J, McDonald SD, Mniszak C, Molinaro ML, Pahwa M, Patel T, Sadik M, Sanya N, Shen K, Greyson D. How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol. PLoS One 2023; 18:e0288952. [PMID: 37561748 PMCID: PMC10414672 DOI: 10.1371/journal.pone.0288952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Pregnant people have a higher risk of severe COVID-19 disease. They have been disproportionately impacted by COVID-19 infection control policies, which exacerbated conditions resulting in intimate partner violence, healthcare access, and mental health distress. This project examines the impact of accumulated individual health decisions and describes how perinatal care and health outcomes changed during the COVID-19 pandemic. OBJECTIVES Quantitative strand: Describe differences between 2019, 2021, and 2022 birth groups related to maternal vaccination, perinatal care, and mental health care. Examine the differential impacts on racialized and low-income pregnant people.Qualitative strand: Understand how pregnant people's perceptions of COVID-19 risk influenced their decision-making about vaccination, perinatal care, social support, and mental health. METHODS AND ANALYSIS This is a Canadian convergent parallel mixed-methods study. The quantitative strand uses a retrospective cohort design to assess birth group differences in rates of Tdap and COVID-19 vaccination, gestational diabetes screening, length of post-partum hospital stay, and onset of depression, anxiety, and adjustment disorder, using administrative data from ICES, formerly the Institute for Clinical Evaluative Sciences (Ontario) and PopulationData BC (PopData) (British Columbia). Differences by socioeconomic and ethnocultural status will also be examined. The qualitative strand employs qualitative description to interview people who gave birth between May 2020- December 2021 about their COVID-19 risk perception and health decision-making process. Data integration will occur during design and interpretation. ETHICS AND DISSEMINATION This study received ethical approval from McMaster University and the University of British Columbia. Findings will be disseminated via manuscripts, presentations, and patient-facing infographics. TRIAL REGISTRATION Registration: Clinicaltrials.gov registration number: NCT05663762.
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Affiliation(s)
- Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rebecca H. Correia
- Health Research Methodology Graduate Program, McMaster University, Hamilton, Canada
| | - Michelle Howard
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Elizabeth Darling
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Hamideh Bayrampour
- Department of Family Practice, Midwifery Program, University of British Columbia, University Endowment Lands, Canada
| | - Andrea Carruthers
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Amie Davis
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Dima Hadid
- Health Policy PhD Program, McMaster University, Hamilton, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sujane Kandasamy
- Department of Child and Youth Health, Brock University, St. Catharines, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | - Jessica Liauw
- Department of Obstetrics and Gynecology, University of British Columbia, University Endowment Lands, Canada
| | - Sarah D. McDonald
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Radiology, McMaster University, Hamilton, Canada
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Caroline Mniszak
- School of Population and Public Health, University of British Columbia, University Endowment Lands, Canada
| | | | - Manisha Pahwa
- Health Policy PhD Program, McMaster University, Hamilton, Canada
| | - Tejal Patel
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Marina Sadik
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Njideka Sanya
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Katrina Shen
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, University Endowment Lands, Canada
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COVID-19 Vaccination Status among Pregnant and Postpartum Women-A Cross-Sectional Study on More Than 1000 Individuals. Vaccines (Basel) 2022; 10:vaccines10081179. [PMID: 35893827 PMCID: PMC9330718 DOI: 10.3390/vaccines10081179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023] Open
Abstract
Pregnancy is a well-known factor for vaccine hesitancy and immunization remains the most effective form of prevention against coronavirus disease (COVID-19) related complications. The objective was to estimate vaccine uptake and hesitancy rate, characteristics, and factors contributing to a decision-making process among pregnant and postpartum individuals. This was a prospective cross-sectional study on 1033 pregnant (54.1%) and postpartum (45.9%) women conducted between December 2021 and March 2022 in a tertiary center for maternal−fetal medicine. Logistic regression was used to assess characteristics related to the vaccination decision process. Among responders, 74% were vaccinated and 26% were hesitant (9% planning to vaccinate and 17% totally opposed). Only 59.8% were offered a vaccine by healthcare professionals. Women with higher levels of education (OR 2.26, p < 0.0001), who received positive feedback about vaccination (OR 2.74, p = 0.0172), or were informed about COVID-19 complications in pregnancy (OR 2.6, p < 0.0001) were most likely to accept the vaccination. Hesitancy was associated with multiparity (≥3, OR 4.76, p = 0.006), worse educational status (OR 2.29, p < 0.0001), and lack of previous COVID-19 infection (OR 1.89, p < 0.0001). The most common reason for rejection was insufficient safety data (57%). Understanding factors behind vaccination status is crucial in lowering complications in mothers and newborns and targeted action may facilitate the uptake.
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