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妊娠期首三月接种灭活 COVID-19 疫苗的安全性和有效性。

Safety and efficacy of inactivated COVID-19 vaccines in women vaccinated during the first trimester of pregnancy.

机构信息

Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Int J Infect Dis. 2023 May;130:196-202. doi: 10.1016/j.ijid.2023.03.017. Epub 2023 Mar 15.

Abstract

OBJECTIVES

This study aimed to investigate the safety of the inactivated COVID-19 vaccines in early pregnant women in view of their adverse-effect profile and associated maternal-fetal complications, as well as to evaluate their immunogenicity.

METHODS

In this prospective observational cohort study, 232 women in their first trimester or those in the periconception period who inadvertently received two doses of inactivated COVID-19 vaccine between January 21, 2021, and January 14, 2022 were analyzed. Meanwhile, 735 unvaccinated early pregnancy women were also included in the study at a case-to-control ratio of 1:3.

RESULTS

The vaccination group did not have an increased miscarriage rate compared with that of the control group (P = 0.918). Furthermore, the birth defect rates in the vaccine group and control group were 0.83% and 1.0%, respectively. Vaccination did not increase the risk of small for gestational age, gestational diabetes mellitus, preterm, or hypertensive disorders of pregnancy (P >0.01). Within 12 weeks after the second dose, the inactivated vaccine effectively produced neutralizing antibody (NAb) against SARS-CoV-2. The NAb levels in the paired umbilical cord serum and maternal serum samples during delivery were negative in both groups. The T-cell subset remained within the normal range in both groups.

CONCLUSION

Therefore, our study proves that inactivated COVID-19 vaccines are safe for mothers and fetuses and also effective in producing NAb against SARS-CoV-2.

摘要

目的

本研究旨在调查已接种两剂灭活 COVID-19 疫苗的早期妊娠妇女的安全性,包括其不良事件谱和母婴并发症,并评估其免疫原性。

方法

在这项前瞻性观察性队列研究中,分析了 232 名在妊娠早期或围孕期无意中于 2021 年 1 月 21 日至 2022 年 1 月 14 日期间接种两剂灭活 COVID-19 疫苗的妇女,同时,按照 1:3 的病例对照比纳入了 735 名未接种的早期妊娠妇女。

结果

与对照组相比,接种组的流产率没有增加(P=0.918)。此外,接种组和对照组的出生缺陷率分别为 0.83%和 1.0%。接种疫苗不会增加小于胎龄儿、妊娠糖尿病、早产或妊娠高血压疾病的风险(P>0.01)。在第二剂后 12 周内,灭活疫苗有效地产生了针对 SARS-CoV-2 的中和抗体(NAb)。两组在分娩时脐带血清和母血清样本中的 NAb 水平均为阴性。两组的 T 细胞亚群均保持在正常范围内。

结论

因此,我们的研究证明,灭活 COVID-19 疫苗对母亲和胎儿是安全的,并且能有效地产生针对 SARS-CoV-2 的 NAb。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e496/10014124/fc1b90d95f69/gr1_lrg.jpg

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