Bosworth Matthew L, Schofield Ryan, Ayoubkhani Daniel, Charlton Loes, Nafilyan Vahé, Khunti Kamlesh, Zaccardi Francesco, Gillies Clare, Akbari Ashley, Knight Marian, Wood Rachael, Hardelid Pia, Zuccolo Luisa, Harrison Camille
Office for National Statistics, Newport, UK.
Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
BMJ Med. 2023 Jul 10;2(1):e000403. doi: 10.1136/bmjmed-2022-000403. eCollection 2023.
To estimate vaccine effectiveness for preventing covid-19 related hospital admission in individuals first infected with the SARS-CoV-2 virus during pregnancy compared with those of reproductive age who were not pregnant when first infected with the virus.
Population based cohort study.
Office for National Statistics Public Health Data Asset linked dataset, providing national linked census and administrative data in England, 8 December 2020 to 31 August 2021.
815 477 females aged 18-45 years (mean age 30.4 years) who had documented evidence of a first SARS-CoV-2 infection in the NHS Test and Trace or Hospital Episode Statistics data.
Hospital admission where covid-19 was recorded as the primary diagnosis. Cox proportional hazards models, adjusted for calendar time of infection, sociodemographic factors, and pre-existing health conditions related to uptake of the covid-19 vaccine and risk of severe covid-19 outcomes, were used to estimate vaccine effectiveness as the complement of the hazard ratio for hospital admission for covid-19.
Compared with pregnant individuals who were not vaccinated, the adjusted rate of hospital admission for covid-19 was 77% (95% confidence interval 70% to 82%) lower for pregnant individuals who had received one dose and 83% (76% to 89%) lower for those who had received two doses of vaccine. These estimates were similar to those found in the non-pregnant group: 79% (77% to 81%) for one dose and 83% (82% to 85%) for two doses of vaccine. Among those who were vaccinated >90 days before infection, having two doses of vaccine was associated with a greater reduction in risk than one dose.
Covid-19 vaccination was associated with reduced rates of hospital admission in pregnant individuals infected with the SARS-CoV-2 virus, and the reduction in risk was similar to that in non-pregnant individuals. Waning of vaccine effectiveness occurred more quickly after one than after two doses of vaccine.
评估与首次感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒时未怀孕的育龄个体相比，孕期首次感染该病毒的个体预防新冠病毒相关住院的疫苗有效性。
基于人群的队列研究。
国家统计局公共卫生数据资产链接数据集，提供2020年12月8日至2021年8月31日英格兰的全国链接人口普查和行政数据。
815477名年龄在18至45岁（平均年龄30.4岁）的女性，她们在英国国民医疗服务体系（NHS）检测与追踪或医院事件统计数据中有首次感染SARS-CoV-2的记录证据。
将新冠病毒记录为主要诊断的住院情况。采用Cox比例风险模型，对感染的日历时间、社会人口学因素以及与接种新冠疫苗和严重新冠病毒感染结局风险相关的既往健康状况进行调整，以估计疫苗有效性，即新冠病毒住院风险比的互补值。
与未接种疫苗的孕妇相比，接种一剂疫苗的孕妇因新冠病毒住院的调整率低77%（95%置信区间为70%至82%），接种两剂疫苗的孕妇低83%（76%至89%）。这些估计值与非孕妇组相似：接种一剂疫苗的为79%（77%至81%），接种两剂疫苗的为83%（82%至85%）。在感染前90天以上接种疫苗的人群中，接种两剂疫苗比接种一剂疫苗的风险降低幅度更大。
新冠病毒疫苗接种与感染SARS-CoV-2病毒的孕妇住院率降低相关，且风险降低情况与非孕妇相似。一剂疫苗后疫苗有效性的下降比两剂疫苗后更快。
