Shanghai Key Laboratory of Maternal-Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
J Med Virol. 2023 Jan;95(1):e28245. doi: 10.1002/jmv.28245. Epub 2022 Oct 28.
Despite the high vaccination coverage, potential COVID-19 vaccine-induced adverse effects, especially in pregnant women, have not been fully characterized. We examined the association between COVID-19 vaccination before conception and maternal thyroid function during early pregnancy. We conducted a retrospective cohort study in Shanghai, China. A total of 6979 pregnant women were included. Vaccine administration was obtained from electronic vaccination records. Serum levels of thyroid hormone were measured by fluorescence and chemiluminescence immunoassays. Among the 6979 included pregnant women, 3470 (49.7%) received at least two doses of an inactivated vaccine. COVID-19 vaccination had a statistically significant association with both maternal serum levels of free thyroxine (FT4) and thyroid stimulating hormone (TSH). Compared with unvaccinated pregnant women, the mean FT4 levels were lower in pregnant women who had been vaccinated within 3 months before the date of conception by 0.27 pmol/L (β = -0.27, 95% confidence interval [CI], -0.42, -0.12), and the mean TSH levels were higher by 0.08 mIU/L (β = 0.08, 95% CI, 0.00, 0.15). However, when the interval from vaccination to conception was prolonged to more than 3 months, COVID-19 vaccination was not associated with serum FT4 or TSH levels. Moreover, we found that COVID-19 vaccination did not significantly associate with maternal hypothyroidism. Our study suggested that vaccination with inactivated COVID-19 vaccines before conception might result in a small change in maternal thyroid function, but this did not reach clinically significant levels.
尽管疫苗接种率很高，但 COVID-19 疫苗潜在的不良反应，尤其是在孕妇中，尚未得到充分描述。我们研究了妊娠前接种 COVID-19 疫苗与妊娠早期母体甲状腺功能之间的关系。我们在中国上海进行了一项回顾性队列研究。共纳入 6979 名孕妇。疫苗接种情况通过电子疫苗记录获得。甲状腺激素水平通过荧光和化学发光免疫分析测定。在纳入的 6979 名孕妇中，有 3470 名（49.7%）至少接种了两剂灭活疫苗。COVID-19 疫苗接种与游离甲状腺素（FT4）和促甲状腺激素（TSH）的母血清水平均有统计学显著关联。与未接种疫苗的孕妇相比，在受孕日期前 3 个月内接种疫苗的孕妇的 FT4 水平平均降低 0.27 pmol/L（β=-0.27，95%置信区间 [CI]，-0.42，-0.12），TSH 水平平均升高 0.08 mIU/L（β=0.08，95% CI，0.00，0.15）。然而，当从接种疫苗到受孕的间隔延长至 3 个月以上时，COVID-19 疫苗接种与血清 FT4 或 TSH 水平无关。此外，我们发现 COVID-19 疫苗接种与母体甲状腺功能减退症无显著关联。我们的研究表明，妊娠前接种灭活 COVID-19 疫苗可能导致母体甲状腺功能出现微小变化，但未达到临床显著水平。
