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COVID-19 疫苗接种:产前和产前期的考虑因素,包括证据分析和问题讨论。

COVID-19 vaccinations pre- and antepartum: a consideration of the evidence and discussion of issues.

机构信息

Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.

Faculty of Medicine, McGill University, Montreal, QC, Canada.

出版信息

Arch Gynecol Obstet. 2024 Oct;310(4):1805-1810. doi: 10.1007/s00404-024-07701-0. Epub 2024 Aug 28.

Abstract

PURPOSE

The COVID-19 vaccine should be universally offered to pregnant women and women planning pregnancies. This is on the basis that COVID-19 infection can complicate the pregnancy and have adverse health implications in pregnancy, as compared to non-pregnant women, which the vaccine helps to mitigate. This is the recommendation of many governing bodies in medical care. However, certain issues require consideration, which are not discussed in the current guidelines. These include the induction of fever by the vaccines and the role fever can play in teratogenicity, the induction of hyper-coagulable and thrombocytopenic states by the vaccines and other known contraindications to the vaccines. In this article, we develop strategies to minimize risks in these situations. We also discuss the theoretical advantage of calling for a booster COVID-19 vaccinate in all pregnant women in the late second or early third trimester, even if previously immunized, and encourage further research, to investigate the possible benefits of this proposed intervention. This article acts as an educational supplement to help clinicians manage pregnant women and addresses many issues, not discussed in most COVID-19 vaccine recommendations by international societies related to pregnant women.

METHODS

This article is a literature review of the current, limited data. The information extrapolated allowed for suggestions regarding COVID-19 vaccination during pregnancy. RESULTS AND CONCLUSIONS: The study discusses hypothetical issues, to minimize any risks associated with COVID-19, and serves as a compilation of data to further the current literature, in proving that COVID-19 vaccines have minimal risks in pregnancy.

摘要

目的

应向孕妇和计划怀孕的女性普遍提供 COVID-19 疫苗。这是基于 COVID-19 感染会使妊娠复杂化,并对孕妇的健康产生不良影响,而疫苗有助于减轻这种影响。这是许多医疗保健机构的建议。然而,某些问题需要考虑,而这些问题在当前的指南中并未讨论。这些问题包括疫苗引起的发热以及发热在致畸性中的作用、疫苗引起的高凝和血小板减少状态以及其他已知的疫苗接种禁忌。在本文中,我们制定了策略来最大限度地降低这些情况下的风险。我们还讨论了呼吁在妊娠晚期第二或第三早期向所有孕妇接种 COVID-19 加强针的理论优势,即使之前已经免疫,并鼓励进一步研究,以调查这一拟议干预措施的可能益处。本文作为教育补充,帮助临床医生管理孕妇,并讨论了许多国际社会关于孕妇的 COVID-19 疫苗建议中未讨论的问题。

方法

本文是对当前有限数据的文献回顾。推断出的信息允许对怀孕期间接种 COVID-19 疫苗提出建议。

结果与结论

该研究讨论了假设性问题,以最大限度地降低与 COVID-19 相关的任何风险,并作为进一步阐述当前文献的资料汇编,证明 COVID-19 疫苗在妊娠期间的风险极小。

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