Department of Obstetrics and Gynecology, School of Medicine, Koc University, Istanbul, Turkey.
Pediatric Infectious Diseases Research Group and Vaccine Institute, Institute of Infection and Immunity, St George's University of London, London, England, United Kingdom.
Am J Obstet Gynecol. 2022 Aug;227(2):136-147. doi: 10.1016/j.ajog.2022.05.020. Epub 2022 May 11.
Despite a recent endorsement from official and professional bodies unequivocally recommending COVID-19 vaccination, vaccine hesitancy among pregnant people remains high. The accumulated evidence demonstrates that pregnant people are a special risk group for COVID-19, with an increased risk of intensive care unit admission, extracorporeal membranous oxygenation requirement, preterm birth, and perinatal death. These risks are further increased with some variants of concern, and vaccination of pregnant people reduces the COVID-19-related increase in maternal or fetal morbidity. Data from more than 180,000 vaccinated persons show that immunization against COVID-19 with an mRNA vaccine is safe for pregnant people. Many observational studies comparing perinatal outcomes between vaccinated and unvaccinated pregnant people have had reassuring findings and did not demonstrate harmful effects on pregnancy or the newborn. Immunization with mRNA vaccines does not increase the risk of miscarriage, preterm delivery, low birthweight, maternal or neonatal intensive care unit admission, fetal death, fetal abnormality, or pulmonary embolism. Moreover, observational data corroborate the findings of randomized trials that mRNA vaccination is highly effective at preventing severe SARS-CoV-2 infection in pregnant people, emphasizing that the potential maternal and fetal benefits of vaccination greatly outweigh the potential risks of vaccination. Ensuring pregnant people have unrestricted access to COVID-19 vaccination should be a priority in every country worldwide.
尽管官方和专业机构最近明确建议接种 COVID-19 疫苗，但孕妇对接种疫苗仍持犹豫不决的态度。大量证据表明，孕妇是 COVID-19 的特殊高危人群，她们重症监护病房入住率、体外膜氧合需求、早产和围产儿死亡的风险增加。这些风险在某些关切变体中进一步增加，而孕妇接种疫苗可降低 COVID-19 相关的母婴发病率增加。来自超过 18 万名接种者的数据表明，mRNA 疫苗接种 COVID-19 对孕妇是安全的。许多比较接种和未接种孕妇围产期结局的观察性研究结果令人安心，并未显示对妊娠或新生儿有不良影响。mRNA 疫苗接种不会增加流产、早产、低体重儿、产妇或新生儿重症监护病房入住、胎儿死亡、胎儿异常或肺栓塞的风险。此外，观察性数据证实了随机试验的结果，即 mRNA 疫苗接种可高度有效地预防孕妇严重的 SARS-CoV-2 感染，强调疫苗接种对母婴的潜在益处大大超过了疫苗接种的潜在风险。确保孕妇不受限制地获得 COVID-19 疫苗接种应成为全球每个国家的优先事项。
