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妊娠期接种新冠疫苗对三级保健中心产科和新生儿结局的影响。

Effects of Covid-19 Vaccination during Pregnancy on the Obstetric and Neonatal Outcomes in a Tertiary Health Care Center.

机构信息

Department of Obstetrics and Gynaecology, IMS & SUM Hospital, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar - 751003, Odisha, India.

Department of Paediatrics, Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Sambalpur, Odisha, India.

出版信息

J Mother Child. 2023 Jul 6;27(1):72-78. doi: 10.34763/jmotherandchild.20232701.d-22-00043. eCollection 2023 Jun 1.

Abstract

BACKGROUND

Pregnancy is an immuno-compromised state, and pregnant women with COVID-19 are at an increased risk for adverse pregnancy outcomes. Thus, the Center for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization (ACIP) have advocated for COVID-19 vaccination in pregnant women. COVAXIN and COVISHIELD were the vaccines being used in India in the first phase of vaccination, but limited data exist on pregnancy outcomes regarding SARS-CoV-2 vaccines and pregnancy and lactation.

MATERIAL AND METHODS

A retrospective study was conducted which included only women who delivered after 24 weeks gestation. Women with an unknown vaccination status or with past or active COVID-19 infection were excluded. Demographic characteristics, maternal and obstetric outcomes, and fetal and neonatal outcomes were compared between the unvaccinated and vaccinated groups. Statistical analysis was done with Chi-square testing and the Fisher exact test using SPSS-26 software.

RESULTS

Deliveries before a gestation of 37 weeks were significantly higher in the unvaccinated group compared to the vaccinated group. Rates of vaginal deliveries and preterm deliveries were found to be higher in the unvaccinated population. Women who had taken COVAXIN had a higher rate of adverse events compared to those who had taken COVISHIELD.

CONCLUSION

There were no significant differences in adverse obstetric outcomes attributed to vaccine administration between the vaccinated and unvaccinated pregnant women. The beneficial effects of the vaccines in protecting against COVID-19 infection, particularly in pregnancy, outweigh the minor adverse events associated with vaccine administration.

摘要

背景

妊娠是一种免疫功能受损的状态,COVID-19 孕妇发生不良妊娠结局的风险增加。因此,疾病控制与预防中心(CDC)和免疫接种咨询委员会(ACIP)提倡 COVID-19 孕妇接种疫苗。COVAXIN 和 COVISHIELD 是印度在第一阶段疫苗接种中使用的疫苗,但关于 SARS-CoV-2 疫苗与妊娠和哺乳期的妊娠结局数据有限。

材料和方法

进行了一项回顾性研究,仅包括妊娠 24 周后分娩的妇女。排除了疫苗接种状况未知或过去或现患 COVID-19 感染的妇女。比较了未接种疫苗组和接种疫苗组的人口统计学特征、产妇和产科结局以及胎儿和新生儿结局。使用 SPSS-26 软件进行了卡方检验和 Fisher 确切检验的统计分析。

结果

与接种疫苗组相比,未接种疫苗组的早产(妊娠 37 周前分娩)发生率显著更高。未接种组的阴道分娩率和早产率较高。与接种 COVISHIELD 的女性相比,接种 COVAXIN 的女性不良事件发生率更高。

结论

疫苗接种与未接种孕妇的不良产科结局之间没有显著差异。疫苗在预防 COVID-19 感染方面的有益效果,特别是在妊娠期间,超过了与疫苗接种相关的轻微不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f373/10323967/f85eada4d76a/j_jmotherandchild.20232701.d-22-00043_fig_001.jpg

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