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妊娠期 COVID-19 疫苗接种的剂量和时间依赖性有效性和安全性:系统评价和荟萃分析。

The dose- and time-dependent effectiveness and safety associated with COVID-19 vaccination during pregnancy: a systematic review and meta-analysis.

机构信息

Department of Clinical Medicine, Tongji University School of Medicine, Shanghai, China.

Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Int J Infect Dis. 2023 Mar;128:335-346. doi: 10.1016/j.ijid.2023.01.018. Epub 2023 Jan 25.

DOI:10.1016/j.ijid.2023.01.018
PMID:36707044
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9873368/
Abstract

OBJECTIVES

This study aimed to provide guidance for clinical treatment and increase public confidence in COVID-19 vaccines.

METHODS

The Cochrane Library, Embase, PubMed, Web of Science, ClinicalKey, and other COVID-19 datasets were searched from December 2019 to May 2022. Case-control studies and prospective cohort studies of COVID-19 vaccine effectiveness and safety in pregnant women were included.

RESULTS

From day 11 to day 13, after the first dose of the COVID-19 messenger RNA vaccine, the effectiveness was 54% (95% confidence interval: 0.33-0.69). On days 14 to 27, the effectiveness was 59%. There was a 14% increase in vaccine effectiveness 28 days after the first dose was given. The inactivated vaccines showed similar effectiveness. The proportions of placental abruptions, postpartum hemorrhages, miscarriages, stillbirths, premature births, and small for gestational age infants were not significantly different between vaccinated and nonvaccinated pregnant women. Fatigue and fever were also not associated with pregnancy.

CONCLUSION

Our findings affirm that the effectiveness varies for different types of vaccines and is significantly and positively correlated with time in the pregnant population. COVID-19 vaccines have also been deemed safe for pregnant women. Thus, we developed a comprehensive understanding of the role of vaccines in pregnant women.

摘要

目的

本研究旨在为临床治疗提供指导,并提高公众对 COVID-19 疫苗的信心。

方法

从 2019 年 12 月至 2022 年 5 月,检索了 Cochrane 图书馆、Embase、PubMed、Web of Science、ClinicalKey 和其他 COVID-19 数据集,纳入了关于 COVID-19 疫苗在孕妇中的有效性和安全性的病例对照研究和前瞻性队列研究。

结果

在第一剂 COVID-19 信使 RNA 疫苗接种后第 11 天至第 13 天,疫苗的有效性为 54%(95%置信区间:0.33-0.69)。在第 14 天至第 27 天,有效性为 59%。第一剂疫苗接种后 28 天,疫苗的有效性增加了 14%。灭活疫苗也显示出类似的有效性。接种疫苗和未接种疫苗的孕妇的胎盘早剥、产后出血、流产、死产、早产和小于胎龄儿的比例没有显著差异。疲劳和发热也与妊娠无关。

结论

我们的研究结果证实,不同类型的疫苗的有效性不同,并且与孕妇群体中的时间呈显著正相关。COVID-19 疫苗也被认为对孕妇是安全的。因此,我们对疫苗在孕妇中的作用有了全面的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/0a885c24ccea/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/f01373c0cdaa/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/f48dac9957fe/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/6bab9aab33ec/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/ed9c757b6d6d/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/0a885c24ccea/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/f01373c0cdaa/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/f48dac9957fe/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/6bab9aab33ec/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/ed9c757b6d6d/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c2/9873368/0a885c24ccea/gr5_lrg.jpg

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