Coronavirus Disease 2019 (COVID-19) Vaccines and Pregnancy What Obstetricians Need to Know
Coronavirus Disease 2019 (COVID-19) Vaccines and Pregnancy What Obstetricians Need to Know
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DOI：
10.1097/aog.0000000000004290
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发表时间：
2021-03-01
影响因子：
7.2
通讯作者：
Jamieson, Denise J.
中科院分区：
文献类型：
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作者：
Rasmussen, Sonja A.;Kelley, Colleen F.;Jamieson, Denise J.
2019冠状病毒病（COVID-19）疫苗已开始在美国各地分发，并将首先提供给优先群体，包括医疗保健人员和居住在长期护理机构的人员。需要就孕妇是否应该接种COVID-19疫苗提供指导。由于孕妇被排除在COVID-19疫苗的初始3期临床试验之外，因此有关其在怀孕期间的有效性和安全性的数据有限。在发育和生殖毒理学研究完成后，预计一些公司将在孕妇中进行临床试验。在此之前，孕妇及其产科医生将需要使用现有数据来权衡COVID-19疫苗的益处和风险。在为孕妇提供咨询时需要考虑的问题包括：来自动物研究和疫苗临床试验期间意外暴露妊娠的数据（如可用）、疫苗反应原性对妊娠的潜在风险、妊娠期间接种疫苗的时间、妊娠期间其他疫苗的安全性证据、妊娠引起COVID-19并发症的风险以及孕妇的基础疾病，和接触严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的风险以及降低风险的潜力。美国疾病控制和预防中心、美国妇产科医师学会和母胎医学会分别发布了支持向孕妇提供COVID-19疫苗的指导意见。随着来自临床试验和从接种疫苗的孕妇收集的数据中获得更多信息，产科医生及时了解这些信息至关重要。
Coronavirus disease 2019 (COVID-19) vaccines have begun to be distributed across the United States and to be offered initially to priority groups including health care personnel and persons living in long-term care facilities. Guidance regarding whether pregnant persons should receive a COVID-19 vaccine is needed. Because pregnant persons were excluded from the initial phase 3 clinical trials of COVID-19 vaccines, limited data are available on their efficacy and safety during pregnancy. After developmental and reproductive toxicology studies are completed, some companies are expected to conduct clinical trials in pregnant persons. Until then, pregnant persons and their obstetricians will need to use available data to weigh the benefits and risks of COVID-19 vaccines. Issues to be considered when counseling pregnant persons include data from animal studies and inadvertently exposed pregnancies during vaccine clinical trials when available, potential risks to pregnancy of vaccine reactogenicity, timing of vaccination during pregnancy, evidence for safety of other vaccines during pregnancy, risk of COVID-19 complications due to pregnancy and the pregnant person's underlying conditions, and risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and potential for risk mitigation. The Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine have each issued guidance supportive of offering COVID-19 vaccine to pregnant persons. As additional information from clinical trials and from data collected on vaccinated pregnant persons becomes available, it will be critical for obstetricians to keep up to date with this information.