新冠疫苗对因呼吸道症状住院的孕妇的益处：巴西南部的一项回顾性队列研究

The Benefits of COVID-19 Vaccination for Pregnant Patients Hospitalized with Respiratory Symptoms: A Retrospective Cohort Study in South Brazil.

作者信息

Hernandez Christopher J, Sundar Kavya G, Echegaray Fernando, Cambou Mary Catherine, Yang Lanbo Z, Segura Eddy R, Gonçalves de Melo Marineide, Santos Breno Riegel, Varella Ivana Rosângela Dos Santos, Nielsen-Saines Karin

机构信息

UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.

Cooper Medical School of Rowan University, Camden, NJ 08103, USA.

出版信息

Vaccines (Basel). 2024 Dec 22;12(12):1445. doi: 10.3390/vaccines12121445.

DOI:10.3390/vaccines12121445

PMID:39772105

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11680175/

Abstract

OBJECTIVES

SARS-CoV-2 infection is a known risk factor for adverse health outcomes in pregnancy, affecting both maternal and neonatal health. Mounting evidence suggests that even a single dose of an approved COVID-19 vaccine protects against severe SARS-CoV-2 infection and is safe for both pregnant persons and neonates. Southern Brazil was heavily affected by the COVID-19 pandemic, and the protective effects of the vaccine on maternal and neonatal health are not well described. This study aims to examine the protective effects of maternal COVID-19 vaccination on both maternal and neonatal outcomes following SARS-CoV-2 infection during pregnancy.

METHODS

This is a retrospective cohort study that leveraged medical data from a tertiary center in South Brazil to compare maternal and infant outcomes between hospitalized pregnant persons with and without SARS-CoV-2 infection between 1 March 2020, and 1 March 2023.

RESULTS

In total, 524 patients were enrolled, including 275 pregnant patients with confirmed SARS-CoV-2 infection and 249 without infection. SARS-CoV-2 infection was associated with maternal ventilator support (adjusted Risk Ratio [aRR] = 1.48, 95% Confidence Interval [95% CI]: 1.08-2.03), while receipt of at least one dose of COVID-19 vaccine was associated with protection against maternal sepsis (aRR = 0.14, 95% CI: 0.03-0.56), intensive care unit (ICU) admission (aRR = 0.27, 95% CI: 0.10-0.68), need for ventilator support (aRR = 0.60, 95% CI: 0.43-0.84), infant admission to the neonatal intensive care unit (NICU) (aRR = 0.62, 95% CI: 0.47-0.82), and neonatal respiratory distress (aRR = 0.60, 95% CI: 0.43-0.83).

CONCLUSIONS

These findings further underscore the importance of maternal vaccination against COVID-19 during pregnancy. Even one dose of vaccine was protective against a variety of maternal and neonatal outcomes. Prenatal care should encourage COVID-19 vaccination in pregnancy.

摘要

目的

严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染是已知的妊娠不良健康结局的危险因素，会影响孕产妇和新生儿健康。越来越多的证据表明，即使单剂获批的2019冠状病毒病（COVID-19）疫苗也能预防严重的SARS-CoV-2感染，且对孕妇和新生儿均安全。巴西南部受COVID-19大流行的影响严重，而疫苗对孕产妇和新生儿健康的保护作用尚未得到充分描述。本研究旨在探讨孕期COVID-19疫苗接种对孕产妇感染SARS-CoV-2后母婴结局的保护作用。

方法

这是一项回顾性队列研究，利用巴西南部一家三级中心的医疗数据，比较2020年3月1日至2023年3月1日期间住院的感染和未感染SARS-CoV-2的孕妇的母婴结局。

结果

共纳入524例患者，其中275例为确诊SARS-CoV-2感染的孕妇，249例为未感染孕妇。SARS-CoV-2感染与孕产妇机械通气支持相关（调整风险比[aRR]=1.48，95%置信区间[95%CI]：1.08-2.03），而接种至少一剂COVID-19疫苗与预防孕产妇败血症（aRR=0.14，95%CI：0.03-0.56）、入住重症监护病房（ICU）（aRR=0.27，95%CI：0.10-0.68）、需要机械通气支持（aRR=0.60，95%CI：0.43-0.84）、婴儿入住新生儿重症监护病房（NICU）（aRR=0.62，95%CI：0.47-0.82）以及新生儿呼吸窘迫（aRR=0.60，95%CI：0.43-0.83）相关。