Huiberts Anne J, Oosting Ilse J, de Melker Hester E, van de Wijgert Janneke H H M, Grobbee Diederick E, van den Hof Susan, Knol Mirjam J
Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
Epidemiol Infect. 2024 Dec 16;153:e5. doi: 10.1017/S0950268824001766.
This study explored the effect of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy on neonatal outcomes among women from the general Dutch population. VASCO is an ongoing prospective cohort study aimed at assessing vaccine effectiveness of COVID-19 vaccination. Pregnancy status was reported at baseline and through regular follow-up questionnaires. As an extension to the main study, all female participants who reported to have been pregnant between enrolment (May-December 2021) and January 2023 were requested to complete an additional questionnaire on neonatal outcomes. Multivariable linear and logistic regression analyses were used to determine the associations between self-reported SARS-CoV-2 infection or COVID-19 vaccination during pregnancy and neonatal outcomes, adjusted for age, educational level, and presence of a medical risk condition. Infection analyses were additionally adjusted for COVID-19 vaccination before and during pregnancy, and vaccination analyses for SARS-CoV-2 infection before and during pregnancy. Of 312 eligible participants, 232 (74%) completed the questionnaire. In total, 196 COVID-19 vaccinations and 115 SARS-CoV-2 infections during pregnancy were reported. Infections were mostly first infections (86; 75%), caused by the Omicron variant (95; 83%), in women who had received ≥1 vaccination prior to infection (101; 88%). SARS-CoV-2 infection during pregnancy was not significantly associated with gestational age ( = 1.7; 95%CI: -1.6-5.0), birth weight ( = 82; -59 to 223), Apgar score <9 (odds ratio (OR): 1.3; 0.6-2.9), postpartum hospital stay (OR: 1.0; 0.6-1.8), or neonatal intensive care unit admission (OR: 0.8; 0.2-3.2). COVID-19 vaccination during pregnancy was not significantly associated with gestational age ( = -0.4; -4.0 to 3.2), birth weight ( = 88; -64 to 240), Apgar score <9 (OR: 0.9; 0.4-2.3), postpartum hospital stay (OR: 0.9; 0.5-1.7), or neonatal intensive care unit admission (OR: 1.6; 0.4-8.6). In conclusion, this study did not find an effect of SARS-CoV-2 infection or COVID-19 vaccination during pregnancy on any of the studied neonatal outcomes among a general Dutch, largely vaccinated, population. Together with data from other studies, this supports the safety of COVID-19 vaccination during pregnancy.
本研究探讨了荷兰普通人群中孕妇感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）及接种2019冠状病毒病（COVID-19）疫苗对新生儿结局的影响。VASCO是一项正在进行的前瞻性队列研究，旨在评估COVID-19疫苗的有效性。在基线时以及通过定期随访问卷报告妊娠状态。作为主要研究的扩展，要求所有在入组（2021年5月至12月）至2023年1月期间报告怀孕的女性参与者填写一份关于新生儿结局的附加问卷。采用多变量线性和逻辑回归分析来确定自我报告的孕期SARS-CoV-2感染或COVID-19疫苗接种与新生儿结局之间的关联，并对年龄、教育水平和是否存在医疗风险状况进行了调整。感染分析还对孕期前后的COVID-19疫苗接种情况进行了调整，疫苗接种分析则对孕期前后的SARS-CoV-2感染情况进行了调整。在312名符合条件的参与者中，232名（74%）完成了问卷。总共报告了孕期196次COVID-19疫苗接种和115次SARS-CoV-2感染。感染大多为初次感染（86例；75%），由奥密克戎变异株引起（95例；83%），感染前已接种≥1剂疫苗的女性（101例；88%）。孕期SARS-CoV-2感染与孕周（β = 1.7；95%置信区间：-1.6至5.0）、出生体重（β = 82；-59至223）、阿氏评分<9（比值比（OR）：1.3；0.6至2.9）、产后住院时间（OR：1.0；0.6至1.8）或新生儿重症监护病房入院（OR：0.8；0.2至3.2）均无显著关联。孕期COVID-19疫苗接种与孕周（β = -0.4；-4.0至3.2）、出生体重（β = 88；-64至240）、阿氏评分<9（OR：0.9；0.4至2.3）、产后住院时间（OR：0.9；0.5至1.7）或新生儿重症监护病房入院（OR：1.6；0.4至8.6）均无显著关联。总之，本研究未发现荷兰普通人群（大部分已接种疫苗）中孕期SARS-CoV-2感染或COVID-19疫苗接种对任何研究的新生儿结局有影响。与其他研究的数据一起，这支持了孕期接种COVID-19疫苗的安全性。
