1
|
Mohanty S, Tita AT, Varner M, Stockwell MS, Newes‐Adeyi G, Battarbee AN, Reichle L, Morrill T, Daugherty M, Mourad M, Silverio Francisco RA, Woodworth K, Wielgosz K, Galang R, Maniatis P, Semenova V, Dawood FS. Association between SARS-CoV-2 infections during pregnancy and preterm live birth. Influenza Other Respir Viruses 2023; 17:e13192. [PMID: 37744991 PMCID: PMC10511836 DOI: 10.1111/irv.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
We examined associations between mild or asymptomatic prenatal SARS-CoV-2 infection and preterm live birth in a prospective cohort study. During August 2020-October 2021, pregnant persons were followed with systematic surveillance for RT-PCR or serologically confirmed SARS-CoV-2 infection until pregnancy end. The association between prenatal SARS-CoV-2 infection and preterm birth was assessed using Cox proportional-hazards regression. Among 954 pregnant persons with a live birth, 185 (19%) had prenatal SARS-CoV-2 infection and 123 (13%) had preterm birth. The adjusted hazard ratio for the association between SARS-CoV-2 infection and preterm birth was 1.28 (95% confidence interval 0.82-1.99, p = 0.28), although results did not reach statistical significance.
Collapse
Affiliation(s)
- Sarita Mohanty
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Alan T. Tita
- Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal‐Fetal MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Michael Varner
- Department of Obstetrics and GynecologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
| | - Melissa S. Stockwell
- Division of Child and Adolescent Health, Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Department of Population and Family Health, Mailman School of Public HealthColumbia University Irving Medical CenterNew YorkNew YorkUSA
- New York‐Presbyterian HospitalNew YorkNew YorkUSA
| | | | - Ashley N. Battarbee
- Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal‐Fetal MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | | | | | | | - Mirella Mourad
- Division of Child and Adolescent Health, Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Raul A. Silverio Francisco
- Division of Child and Adolescent Health, Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Kate Woodworth
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | | | - Romeo Galang
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Pete Maniatis
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Vera Semenova
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | | |
Collapse
|
2
|
Dawood FS, Tita A, Stockwell MS, Newes-Adeyi G, Wielgosz K, Gyamfi-Bannerman C, Battarbee A, Reichle L, Thornburg N, Ellington S, Galang RR, Vorwaller K, Vargas CY, Morrill T, Parks M, Powers E, Gibson M, Varner M. Neutralizing Antibody Responses to Messenger RNA Coronavirus Disease 2019 Vaccines Versus Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Pregnant Women and Vaccine-Induced Antibody Transfer to Infants. Open Forum Infect Dis 2023; 10:ofad204. [PMID: 37187508 PMCID: PMC10167992 DOI: 10.1093/ofid/ofad204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Background Early coronavirus disease 2019 (COVID-19) vaccine trials excluded pregnant women, resulting in limited data about immunogenicity and maternal-fetal antibody transfer, particularly by gestational timing of vaccination. Methods In this multicenter observational immunogenicity study, pregnant and nonpregnant women receiving COVID-19 vaccines were prospectively enrolled. Participants had sera collected before vaccination, at 14-28 days after each vaccine dose, at delivery (umbilical cord and peripheral), and from their infants at 3 and 6 months. Geometric mean titers (GMTs) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ID50 neutralizing antibody (nAb) against D614G-like viruses were compared by participant characteristics. Results Overall, 23 nonpregnant and 85 pregnant participants (trimester of first vaccine dose: 10 first, 47 second, 28 third) were enrolled. Ninety-three percent (76/82 with blood samples) of pregnant participants had detectable SARS-CoV-2 nAb after 2 vaccine doses, but GMTs (95% confidence intervals) were lower in pregnant participants than nonpregnant participants (1722 [1136-2612] vs 4419 [2012-9703]; P = .04). By 3 and 6 months, 28% and 74% of infants, respectively, of vaccinated participants had no detectable nAb to D614G-like viruses. Among the 71 pregnant participants without detectable nAb before vaccination, cord blood GMTs at delivery were 5-fold higher among participants vaccinated during the third versus first trimester, and cord blood nAb titers appeared inversely correlated with weeks since first vaccine dose (R2 = 0.06, P = .06). Conclusions Though most pregnant women develop nAb after 2 doses of mRNA COVID-19 vaccines, this analysis suggests that infant protection from maternal vaccination varies by gestational timing of vaccination and wanes. Additional prevention strategies such as caregiver vaccination may warrant consideration to optimize infant protection.
Collapse
Affiliation(s)
- Fatimah S Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alan Tita
- Center for Women's Reproductive Health and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa S Stockwell
- New York–Presbyterian Hospital, New York, New York, USA
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Kristina Wielgosz
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia Gyamfi-Bannerman
- New York–Presbyterian Hospital, New York, New York, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, California, USA
| | - Ashley Battarbee
- Center for Women's Reproductive Health and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Natalie Thornburg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sascha Ellington
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Romeo R Galang
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelly Vorwaller
- Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | | | | | - Mickey Parks
- Center for Women's Reproductive Health and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Emily Powers
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Marie Gibson
- Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Michael Varner
- Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| |
Collapse
|
3
|
Wielgosz K, Dawood FS, Stockwell MS, Varner M, Newes-Adeyi G, Ellington S, Vargas C, Bruno AM, Powers E, Morrill T, Reichle L, Battarbee AN, Tita AT. Agreement Between Pregnant Individuals' Self-Report of Coronavirus Disease 2019 (COVID-19) Vaccination and Medical Record Documentation. Obstet Gynecol 2022; 140:989-992. [PMID: 36357976 PMCID: PMC10563869 DOI: 10.1097/aog.0000000000004994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022]
Abstract
For public health research such as vaccine uptake or effectiveness assessments, self-reported coronavirus disease 2019 (COVID-19) vaccination status may be a more efficient measure than verifying vaccination status from medical records if agreement between sources is high. We assessed agreement between self-reported and medical record-documented COVID-19 vaccination status among pregnant individuals followed in a cohort during August 2020-October 2021. At end of pregnancy, participants completed questionnaires about COVID-19 vaccine receipt during pregnancy; staff verified vaccination status using medical records. Agreement was assessed between self-reported and medical record vaccination status using Cohen's kappa. There was high agreement between self-reported and medical record vaccination status (Kappa coefficient=0.94, 95% CI 0.91-0.98), suggesting that self-report may be acceptable for ascertaining COVID-19 vaccination status during pregnancy.
Collapse
Affiliation(s)
| | | | - Melissa S. Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Michael Varner
- Department of Obstetrics and Gynecology, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | | | | | - Celibell Vargas
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Ann M. Bruno
- Department of Obstetrics and Gynecology, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Emily Powers
- Department of Obstetrics and Gynecology, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | | | | | - Ashley N. Battarbee
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Alan T. Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
4
|
Traczewski W, Moskala M, Kruk D, Gościński I, Szwabowska D, Polak J, Wielgosz K. The role of computerized rheoencephalography in the assessment of normal pressure hydrocephalus. J Neurotrauma 2005; 22:836-43. [PMID: 16004585 DOI: 10.1089/neu.2005.22.836] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the relationship between arterial compliance derived from rheoencephalography (REG), and the slope of the regression line between pulse amplitude and mean ICP (AMP/P) recorded during a lumbar infusion study. A hypothetical link between these two variables has been suggested in the past. Resistance to the outflow of cerebrospinal fluid (R(out)) and the slope of the amplitude pressure regression line (AMP/P) were calculated in 62 patients diagnosed with posttraumatic normal pressure hydrocephalus (NPH). In all patients, the changes in cerebral electrical impedance related to the pulsatile component of blood flow were studied noninvasively using computerized rheoencephalography. We classified the REG pulse-related waveform (REGpw) according to the number of the inflection points in the ascending branch, which are a manifestation of the elastic properties of the small arteries. In normal subjects, REGpw corresponded with only one inflection point in the ascending branch (category I). For the purpose of this study, we assumed that the presence of three or greater number of inflection points was characteristic of the regressive changes of the arterial wall (category II). The slope of the AMP/P in patients with the category I REGpw was significantly lower than that in patients with category II (p < 0.05). The association between REGpw category II and the increased slope of the aAMP/P regression line may be related to the transmission of the pulse pressure waveform arterial wall to the CSF compartment, which in turn depends on the elastic properties of the cerebral arteries. The outcome of shunting in patients with REGpw category I was significantly better than that in patients with category II, suggesting that small artery disease may be linked to worse clinical outcomes. Our study indicates that REG examination has potential clinical value in diagnosis and prognosis of NPH.
Collapse
Affiliation(s)
- W Traczewski
- Department of Neurotraumatology, Jagellonian University, Cracow, Poland
| | | | | | | | | | | | | |
Collapse
|