Conte Ennio, Di Girolamo Raffaella, D'Antonio Francesco, Raffone Antonio, Neola Daniele, Saccone Gabriele, Dell'Aquila Michela, Sarno Laura, Miceli Marco, Carbone Luigi, Maruotti Giuseppe Maria
Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy.
Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, 66100 Chieti, Italy.
Vaccines (Basel). 2023 Feb 3;11(2):344. doi: 10.3390/vaccines11020344.
Monoclonal antibodies (mAbs) have been used as a rescue strategy for pregnant women affected by COVID-19. To explore its impact on maternal-fetal health, we included all observational studies reporting maternal, fetal, delivery and neonatal outcomes in women who underwent mAbs infusion for COVID-19. Primary outcome was the percentage of preterm delivery. We used meta-analyses of proportions to combine data for maternal, fetal, delivery and neonatal outcome of women treated with mAbs for COVID-19 and reported pooled proportions and their 95% confidence intervals (CIs) for categorical variables or mean difference (MD) with their 95% confidence intervals for continuous variables. Preterm birth was observed in 22.8% of cases (95% CI 12.9-34.3). Fetal distress was reported in 4.2% (95% CI 1.6-8.2). Gestational hypertension and pre-eclampsia were observed in 3.0% (95% CI 0.8-6.8) and 3.4% (95% CI 0.8-7.5) of cases, respectively. Fetal growth restriction was observed in 3.2% of fetuses (95% CI 0.8-7.0). Secondary prophylaxis with mAbs is currently considered the best treatment option for people with mild to moderate COVID-19 disease. More attention should be paid to infants born from mothers who were treated with mAbs, for the risk of immunosuppression.
单克隆抗体（mAbs）已被用作受新冠病毒病影响的孕妇的一种挽救策略。为探讨其对母婴健康的影响，我们纳入了所有报告接受mAbs输注治疗新冠病毒病的女性的孕产妇、胎儿、分娩及新生儿结局的观察性研究。主要结局是早产的百分比。我们采用比例的荟萃分析来合并接受mAbs治疗新冠病毒病的女性的孕产妇、胎儿、分娩及新生儿结局的数据，并报告分类变量的合并比例及其95%置信区间（CIs），或连续变量的平均差（MD）及其95%置信区间。在22.8%的病例中观察到早产（95%CI 12.9 - 34.3）。报告有4.2%（95%CI 1.6 - 8.2）出现胎儿窘迫。分别在3.0%（95%CI 0.8 - 6.8）和3.4%（95%CI 0.8 - 7.5）的病例中观察到妊娠期高血压和先兆子痫。在3.2%的胎儿中观察到胎儿生长受限（95%CI 0.8 - 7.0）。目前，mAbs的二级预防被认为是轻度至中度新冠病毒病患者的最佳治疗选择。对于接受mAbs治疗的母亲所生的婴儿，应更多关注其免疫抑制风险。
