Pregnancy and birth outcomes after SARS-CoV-2 vaccination in pregnancy.
Pregnancy and birth outcomes after SARS-CoV-2 vaccination in pregnancy.
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DOI：
10.1016/j.ajogmf.2021.100467
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发表时间：
2021-11
影响因子：
6.3
通讯作者：
Swift M
中科院分区：
文献类型：
--
作者：
Theiler RN;Wick M;Mehta R;Weaver AL;Virk A;Swift M
妊娠期间SARS-CoV-2感染与显著的孕产妇发病率和早产率增加有关。出于这个原因，尽管孕妇被排除在疫苗安全性和有效性的初始临床试验之外，但怀孕期间接种COVID-19疫苗得到了多个专业学会的认可，包括美国妇产科医师学会和母胎医学学会。然而，到目前为止，关于怀孕患者接种COVID-19疫苗后的结果的数据很少。评估COVID-19疫苗在妊娠患者中的安全性和有效性。将综合疫苗登记处与综合医疗保健系统的交付数据库相结合，以创建包括接种疫苗患者的交付队列。对产妇的社会人口学数据进行了检查，以确定与COVID-19疫苗接种相关的因素。分析妊娠和分娩结局，包括孕产妇和新生儿妊娠并发症的综合指标，不良结局指数。在分娩队列的2002名患者中，140名（7.0%）在怀孕期间接受了COVID-19疫苗，212名（10.6%）在怀孕期间经历了COVID-19感染。首次接种疫苗时的中位孕龄为32周（范围为13 6/7-40 4/7周），妊娠期间接种疫苗的患者在分娩前感染COVID-19的可能性低于未接种疫苗的患者（2/140 [1.4%] vs 210/1862 [11.3%]; P<.001）。孕妇接种疫苗后，未发生母体COVID-19感染。在多变量logistic回归模型中，与接种疫苗可能性增加显著相关的因素包括年龄较大、母亲受教育程度较高、不吸烟、当前妊娠使用不孕症治疗以及妊娠次数较低。与未接种疫苗的患者相比，在接种疫苗的患者中观察到复合不良结局（7/140 [5.0%] vs 91/1862 [4.9%]; P= 0.95）或其他母体或新生儿并发症（包括血栓栓塞事件和早产）无显著差异。在该出生队列中，接种疫苗的孕妇比未接种疫苗的孕妇感染COVID-19的可能性更小，并且妊娠期间接种COVID-19疫苗与妊娠或分娩并发症增加无关。该队列倾向于妊娠晚期疫苗接种，因此，结果可能无法推广到妊娠早期的疫苗接种。
SARS-CoV-2 infection during pregnancy is associated with significant maternal morbidity and increased rates of preterm birth. For this reason, COVID-19 vaccination in pregnancy has been endorsed by multiple professional societies, including the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, despite the exclusion of pregnant women from initial clinical trials of vaccine safety and efficacy. However, to date, little data exist regarding the outcomes of pregnant patients after COVID-19 vaccination. To assess the safety and efficacy of COVID-19 vaccines in pregnant patients. A comprehensive vaccine registry was combined with a delivery database for an integrated healthcare system to create a delivery cohort that included vaccinated patients. Maternal sociodemographic data were examined to identify factors associated with COVID-19 vaccination. Pregnancy and birth outcomes were analyzed, including a composite measure of maternal and neonatal pregnancy complications, the Adverse Outcome Index. Of 2002 patients in the delivery cohort, 140 (7.0%) received a COVID-19 vaccine during pregnancy, and 212 (10.6%) experienced a COVID-19 infection during pregnancy. The median gestational age at first vaccination was 32 weeks (range, 13 6/7–40 4/7 weeks), and patients vaccinated during pregnancy were less likely than unvaccinated patients to experience COVID-19 infection before delivery (2/140 [1.4%] vs 210/1862 [11.3%]; P<.001). No maternal COVID-19 infection occurred after the vaccination of pregnant patients. Factors significantly associated with increased likelihood of vaccination in a multivariable logistic regression model included older age, higher level of maternal education, being a nonsmoker, use of infertility treatment for the current pregnancy, and lower gravidity. Compared with unvaccinated patients, no significant difference in the composite adverse outcome (7/140 [5.0%] vs 91/1862 [4.9%]; P=.95) or other maternal or neonatal complications, including thromboembolic events and preterm birth, was observed in vaccinated patients. In this birth cohort, vaccinated pregnant women were less likely than unvaccinated pregnant patients to experience COVID-19 infection, and COVID-19 vaccination during pregnancy was not associated with increased pregnancy or delivery complications. The cohort was skewed toward late pregnancy vaccination, and thus, findings may not be generalizable to vaccination during early pregnancy.
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DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
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作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
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通讯作者：
COVE Study Group
影响因子：
26.1
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影响因子：
120.7
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