妊娠期接种COVID-19疫苗对妊娠结局影响的研究进展

doi:10.12280/gjfckx.20230485

摘要/Abstract

摘要：

新型冠状病毒肺炎（corona virus disease 2019，COVID-19）是一种以呼吸道症状为主的急性传染病，迄今尚无特效的治疗方法。除一般的预防措施外，接种疫苗是一种安全、有效的措施。然而，由于孕产妇及哺乳期妇女的群体特殊性，对COVID-19疫苗的安全性和有效性存在疑虑，导致COVID-19疫苗的接种率低，相关数据相对缺乏。但随着妊娠期发生的一系列生理变化，孕妇更容易感染新型冠状病毒，不良妊娠结局发生风险也随之增加。因此，总结COVID-19疫苗在孕产妇中的安全性及有效性证据十分必要，为后续开展相关研究以及COVID-19疫苗的安全性评价提供参考。

关键词: 新型冠状病毒肺炎, COVID-19疫苗, 孕妇, 妊娠结局, 母乳喂养

Abstract:

Corona virus disease 2019 (COVID-19) is an acute infectious disease characterized by respiratory symptoms, and there is no specific treatment so far. In addition to general preventive measures, vaccination is a safe and effective measure. However, due to the group particularity of pregnant and lactating women, there are doubts about the safety and effectiveness of COVID-19 vaccine, resulting in a low coverage rate of COVID-19 vaccine and a relative lack of relevant data. However, with a series of physiological changes during pregnancy, pregnant women are more likely to be infected with the novel coronavirus, and the risk of adverse pregnancy outcomes increases. Therefore, it is necessary to summarize the evidence of the safety and effectiveness of COVID-19 vaccine in pregnant women, so as to provide references for subsequent relevant studies and safety evaluation of COVID-19 vaccine.

Key words: Corona virus disease 2019, COVID-19 vaccines, Pregnant women, Pregnancy outcome, Breast feeding

章敏, 李权. 妊娠期接种COVID-19疫苗对妊娠结局影响的研究进展[J]. 国际妇产科学杂志, 2023, 50(6): 699-703.

ZHANG Min, LI Quan. Research Progress on the Impact to Pregnancy Outcomes of COVID-19 Vaccination during Pregnancy[J]. Journal of International Obstetrics and Gynecology, 2023, 50(6): 699-703.

参考文献 38

[1]	Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019[J]. N Engl J Med, 2020, 382(8):727-733. doi: 10.1056/NEJMoa2001017.
[2]	Gray KJ, Bordt EA, Atyeo C, et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study[J]. Am J Obstet Gynecol, 2021, 225(3):303.e1-e17. doi: 10.1016/j.ajog.2021.03.023.
[3]	Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy[J]. Am J Obstet Gynecol, 2020, 222(6):521-531. doi: 10.1016/j.ajog.2020.03.021. pmid: 32217113
[4]	Oltean I, Tran J, Lawrence S, et al. Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A systematic review[J]. Heliyon, 2021, 7(3):e06393. doi: 10.1016/j.heliyon.2021.e06393.
[5]	Ghi T, di Pasquo E, Mekinian A, et al. Sars-CoV-2 in pregnancy: Why is it better than expected?[J]. Eur J Obstet Gynecol Reprod Biol, 2020, 252:476-478. doi: 10.1016/j.ejogrb.2020.07.025. pmid: 32739606
[6]	Baergen RN, Heller DS. Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings[J]. Pediatr Dev Pathol, 2020, 23(3):177-180. doi: 10.1177/1093526620925569.
[7]	Parums DV. Editorial: Maternal SARS-CoV-2 Infection and Pregnancy Outcomes from Current Global Study Data[J]. Med Sci Monit, 2021, 27:e933831. doi: 10.12659/MSM.933831.
[8]	Kreutz R, Algharably E, Azizi M, et al. Hypertension, the renin-angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19[J]. Cardiovasc Res, 2020, 116(10):1688-1699. doi: 10.1093/cvr/cvaa097. pmid: 32293003
[9]	Lala A, Johnson KW, Januzzi JL, et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection[J]. J Am Coll Cardiol, 2020, 76(5):533-546. doi: 10.1016/j.jacc.2020.06.007. pmid: 32517963
[10]	Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis[J]. Clin Chim Acta, 2020, 506:145-148. doi: 10.1016/j.cca.2020.03.022. pmid: 32178975
[11]	Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19[J]. Kidney Int, 2020, 97(5):829-838. doi: 10.1016/j.kint.2020.03.005. pmid: 32247631
[12]	茅欣怡, 许钰薇, 李文婧, 等. 新型冠状病毒对人类生殖系统的影响[J]. 国际生殖健康/计划生育杂志, 2022, 41(6):476-481,486. doi: 10.12280/gjszjk.20220406.
[13]	Cai Q, Huang D, Yu H, et al. COVID-19: Abnormal liver function tests[J]. J Hepatol, 2020, 73(3):566-574. doi: 10.1016/j.jhep.2020.04.006. pmid: 32298767
[14]	Villar J, Ariff S, Gunier RB, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study[J]. JAMA Pediatr, 2021, 175(8):817-826. doi: 10.1001/jamapediatrics.2021.1050.
[15]	Ma Y, Deng J, Liu Q, et al. Effectiveness and Safety of COVID-19 Vaccine among Pregnant Women in Real-World Studies: A Systematic Review and Meta-Analysis[J]. Vaccines(Basel), 2022, 10(2):246. doi: 10.3390/vaccines10020246.
[16]	Vivanti AJ, Vauloup-Fellous C, Prevot S, et al. Transplacental transmission of SARS-CoV-2 infection[J]. Nat Commun, 2020, 11(1):3572. doi: 10.1038/s41467-020-17436-6. pmid: 32665677
[17]	Hayakawa S, Komine-Aizawa S, Takada K, et al. Anti-SARS-CoV-2 vaccination strategy for pregnant women in Japan[J]. J Obstet Gynaecol Res, 2021, 47(6):1958-1964. doi: 10.1111/jog.14748.
[18]	Stafford IA, Parchem JG, Sibai BM. The coronavirus disease 2019 vaccine in pregnancy: risks, benefits, and recommendations[J]. Am J Obstet Gynecol,2021, 224(5):484-495. doi: 10.1016/j.ajog.2021.01.022.
[19]	Grünebaum A, McCullough LB, Litvak A, et al. Inclusion of pregnant individuals among priority populations for coronavirus disease 2019 vaccination for all 50 states in the United States[J]. Am J Obstet Gynecol, 2021, 224(5):536-539. doi: 10.1016/j.ajog.2021.01.026.
[20]	国家卫生健康委疾病预防控制局. 新冠病毒疫苗接种技术指南(第一版)[J]. 中国卫生经济, 2021, 40(4):封2,前插1.
[21]	Modi N, Ayres-de-Campos D, Bancalari E, et al. Equity in coronavirus disease 2019 vaccine development and deployment[J]. Am J Obstet Gynecol, 2021, 224(5):423-427. doi: 10.1016/j.ajog.2021.01.006.
[22]	Schaler L, Wingfield M. COVID-19 vaccine - can it affect fertility?[J]. Ir J Med Sci, 2022, 191(5):2185-2187. doi: 10.1007/s11845-021-02807-9.
[23]	Pramanick A, Kanneganti A, Wong J, et al. A reasoned approach towards administering COVID-19 vaccines to pregnant women[J]. Prenat Diagn, 2021, 41(8):1018-1035. doi: 10.1002/pd.5985.
[24]	Arora M, Lakshmi R. Vaccines-safety in pregnancy[J]. Best Pract Res Clin Obstet Gynaecol, 2021, 76:23-40. doi: 10.1016/j.bpobgyn.2021.02.002. pmid: 33773923
[25]	Abu-Raya B, Maertens K, Edwards KM, et al. Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement[J]. Front Immunol, 2020, 11:1282. doi: 10.3389/fimmu.2020.01282. pmid: 32670282
[26]	Shimabukuro TT, Kim SY, Myers TR, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons[J]. N Engl J Med, 2021, 384(24):2273-2282. doi: 10.1056/NEJMoa2104983.
[27]	Zauche LH, Wallace B, Smoots AN, et al. Receipt of mRNA Covid-19 Vaccines and Risk of Spontaneous Abortion[J]. N Engl J Med, 2021, 385(16):1533-1535. doi: 10.1056/NEJMc2113891.
[28]	Collier AY, McMahan K, Yu J, et al. Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women[J]. JAMA, 2021, 325(23):2370-2380. doi: 10.1001/jama.2021.7563. pmid: 33983379
[29]	张腾, 孟茜, 魏巍, 等. 妊娠早期接种新型冠状病毒灭活疫苗后的急性不良事件及妊娠结局[J]. 中华围产医学杂志, 2023, 26(3):177-185. doi: 10.3760/cma.j.cn113903-20220830-00791.
[30]	李艳颜, 唐海燕, 张家怡, 等. 妊娠期接种新型冠状病毒疫苗的安全性评价[J]. 现代妇产科进展, 2023, 32(3):161-165. doi: 10.13283/j.cnki.xdfckjz.2023.03.001.
[31]	余益香, 闻明. 围妊娠期接种新型冠状病毒肺炎疫苗对妊娠结局的影响[J]. 国际妇产科学杂志, 2023, 50(4):428-432. doi: 10.12280/gjfckx.20230096.
[32]	Wainstock T, Yoles I, Sergienko R, et al. Prenatal maternal COVID-19 vaccination and pregnancy outcomes[J]. Vaccine, 2021, 39(41):6037-6040. doi: 10.1016/j.vaccine.2021.09.012. pmid: 34531079
[33]	Theiler RN, Wick M, Mehta R, et al. Pregnancy and birth outcomes after SARS-CoV-2 vaccination in pregnancy[J]. Am J Obstet Gynecol MFM, 2021, 3(6):100467. doi: 10.1016/j.ajogmf.2021.100467.
[34]	Goldshtein I, Steinberg DM, Kuint J, et al. Association of BNT162b2 COVID-19 Vaccination During Pregnancy With Neonatal and Early Infant Outcomes[J]. JAMA Pediatr, 2022, 176(5):470-477. doi: 10.1001/jamapediatrics.2022.0001. pmid: 35142809
[35]	Kharbanda EO, Haapala J, DeSilva M, et al. Spontaneous Abortion Following COVID-19 Vaccination During Pregnancy[J]. JAMA, 2021, 326(16):1629-1631. doi: 10.1001/jama.2021.15494. pmid: 34495304
[36]	Rasmussen SA, Kelley CF, Horton JP, et al. Coronavirus Disease 2019 (COVID-19) Vaccines and Pregnancy: What Obstetricians Need to Know[J]. Obstet Gynecol, 2021, 137(3):408-414. doi: 10.1097/AOG.0000000000004290. pmid: 33370015
[37]	隽娟, 杨慧霞. 备孕期、孕期和哺乳期接种新型冠状病毒疫苗的建议及依据[J]. 中华围产医学杂志, 2021, 24(1):71-72. doi: 10.3760/cma.j.cn113903-20210103-00004.
[38]	Gray KJ, Bordt EA, Atyeo C, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study[J]. medRxiv,2021 Mar 8:2021.03.07.21253094. doi: 10.1101/2021.03.07.21253094.