Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2183750. doi: 10.1080/14767058.2023.2183750.
Even through the fact that pregnant women are more and more severely infected with COVID-19 disease, there are still doubts about vaccinating these people due to the lack of sufficient evidence base information. So in this systematic review, we decided to study vaccinated and unvaccinated pregnant women regarding maternal, fetal and neonatal complications and outcomes.
Between 30 December 2019 and 15 October 2021, electronic searches were performed on the databases of PubMed, Scopus, Google Scholar, and Cochrane library by searching in English and free full text. Keywords searched included these: maternal outcome, neonatal outcome, pregnancy, and COVID-19 vaccination. Among 451 articles, finally, seven studies were included to study pregnancy outcomes in vaccinated women compared to unvaccinated for systematic review purposes.
In this study 30257 vaccinated women in their third trimester compared to 132339 unvaccinated women in terms of age, the root of delivery, neonatal adverse outcomes. There were no significant differences between two groups in terms of: IUFD, and 1 min Apgar score, C/S rate, and NICU admission between the two groups, however, the rate of SGA, IUFD, and also neonatal jaundice, asphyxia, and hypoglycemia was more significant in the unvaccinated group comparing to the vaccinated group as a result. Among them, the chance of preterm labor pain was reported more among vaccinated patients. Emphasizing that, except 7.3% of the case population, everyone in the second and third trimesters had been vaccinated with mRNA COVID-19 vaccines.
COVID-19 vaccination during the second and third trimesters appears to be the right choice due to the immediate impact of COVID-19 antibodies on the developing fetus and formation of neonatal prophylaxis, as well as the absence of adverse outcomes for both the fetus and mothers.
尽管越来越多的孕妇感染了 COVID-19,但由于缺乏足够的证据基础信息,对于这些人接种疫苗仍存在疑虑。因此,在这项系统评价中,我们决定研究接种和未接种疫苗的孕妇的母婴、胎儿和新生儿并发症和结局。
2019 年 12 月 30 日至 2021 年 10 月 15 日,我们通过在 PubMed、Scopus、Google Scholar 和 Cochrane 图书馆以英文和免费全文进行电子检索,搜索了包括孕产妇结局、新生儿结局、妊娠和 COVID-19 疫苗接种等关键词。在 451 篇文章中,最终有 7 项研究被纳入本系统评价,以研究接种疫苗的孕妇与未接种疫苗的孕妇的妊娠结局。
在这项研究中,30257 名处于妊娠晚期的接种疫苗妇女与 132339 名未接种疫苗妇女在年龄、分娩方式、新生儿不良结局方面进行了比较。两组在 IUFD 和 1 分钟 Apgar 评分、C/S 率、NICU 入院率方面无显著差异,但未接种疫苗组的 SGA、IUFD 以及新生儿黄疸、窒息和低血糖发生率明显高于接种疫苗组。其中,接种疫苗组报告早产疼痛的几率更高。需要强调的是,除了 7.3%的病例人群外,所有处于第二和第三孕期的孕妇都接种了 mRNA COVID-19 疫苗。
由于 COVID-19 抗体对发育中的胎儿和新生儿预防措施的直接影响,以及对胎儿和母亲都没有不良后果,因此在第二和第三孕期接种 COVID-19 疫苗似乎是正确的选择。