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
UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
Cooper Medical School of Rowan University, Camden, NJ 08103, USA.
Vaccines (Basel). 2024 Dec 22;12(12):1445. doi: 10.3390/vaccines12121445.
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.
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.
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).
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.
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。
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。
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。
这些发现进一步强调了孕期孕产妇接种COVID-19疫苗的重要性。即使一剂疫苗也能预防多种孕产妇和新生儿结局。产前护理应鼓励孕期接种COVID-19疫苗。
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