Maternal Outcomes After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Vaccinated Compared With Unvaccinated Pregnant Patients

Morgan, John A; Biggio, Joseph; Martin, Jane; Mussarat, Naiha; Chawla, Harsheen K; Puri, Priya; Williams, Frank B.

doi:10.1097/aog.0000000000004621

Cited by 77 publications

(110 citation statements)

References 6 publications

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“…10 These studies highlight the importance of further research to continue building evidence to help inform patient counseling and build patient confidence in vaccination administration. Immunization against COVID-19 has been shown to protect against infection related morbidity in pregnant women 15 ; our data support its continued use for pregnant patients.…”

Section: Accepted Manuscriptsupporting

confidence: 67%

Safety-Related Outcomes of Novel mRNA COVID-19 Vaccines in Pregnancy

et al. 2022

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Objective: To describe the safety profile and demographic data for a cohort of pregnant individuals who received an mRNA COVID-19 vaccine. Study Design: Prospective cohort study (with exposure matching) of individuals with active pregnancy who underwent immunization with a novel mRNA COVID-19 vaccine matched 1:2 with vaccinated age-matched female non-pregnant controls. Primary outcome was defined as any vaccine-related complaint as defined in the original safety data. Secondary outcomes included specific complaints, COVID-19 screening test and positive COVID-19 test. Results: Eighty-three vaccinated pregnant persons were age-matched with 166 female controls, all of whom were vaccinated between December 2020 and January 2021. There was no difference in race or ethnicity between the groups. The mean BMI of pregnant patients was lower than that of controls (26.1 vs 29.2, p=0.002). Frequency of complaint following vaccine administration was not different between pregnant and non-pregnant patients (18.1% vs 16.9%, P=0.201). Pregnant individuals were more likely to report fever (4.8% vs 0.6%, p=0.044) and gastrointestinal symptoms (4.8% vs 0%, p=0.012). Conclusions: Side effect profiles of Covid 19 vaccine administration at our institution were relatively similar between pregnant and non-pregnant individuals and no serious complications occurred in either group. As COVID-19 infection in pregnancy can have significant morbidity, our data support the continued use of the vaccine for pregnant patients.

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Section: Accepted Manuscriptsupporting

confidence: 67%

Safety-Related Outcomes of Novel mRNA COVID-19 Vaccines in Pregnancy

et al. 2022

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“…A flowchart of study selection process is reported in Figure 2 . We considered 46 records: 30 of them included pregnant mothers [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], two studies included both pregnant and lactating mothers [ 39 , 40 ], and 14 studies included lactating mothers [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Most studies were conducted in the United States (41.3%) and Israel (26.1%), along with three in Italy (6.5%), two in Spain (4.3%) and in Poland (4.3%), and the remaining (17.2%) in the United Kingdom, Qatar, Belgium, Germany, Norway, Portugal, the Netherlands, and Singapore.…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 Vaccines during Pregnancy and Breastfeeding: A Systematic Review of Maternal and Neonatal Outcomes

Rose

Salvatori

Dotta

et al. 2022

Viruses

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PubMed, Cochrane Library, and the Education Resources Information Center (ERIC) were searched up to 27 October 2021. The primary outcome was to estimate how many pregnant and lactating women were reported to be vaccinated and had available maternal and neonatal outcomes. (3) Results: Forty-five studies sourcing data of 74,908 pregnant women and 5098 lactating women who received COVID-19 vaccination were considered as eligible. No major side-effects were reported, especially during the second and third trimester of pregnancy and during breastfeeding. Conversely, available studies revealed that infants received specific SARS-CoV-2 antibodies after maternal vaccination. (4) Conclusion: Vaccination against the SARS-CoV-2 virus should be recommended for pregnant women, after the pros and cons have been adequately explained. In particular, given the still limited evidence and considering that fever during the first months of gestation increases the possibility of congenital anomalies, they should be carefully counseled. The same considerations apply to breastfeeding women, also considering the immune responses that mRNA vaccines can generate in their human milk.

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“…During this period, women in the UK were recommended to shield as they were classed as being clinically vulnerable and SARS-CoV-2 vaccinations for pregnant women were not approved by the Joint Committee on Vaccination and Immunization (JCVI) until April 2021 (29). Maternal vaccination has been found to reduce severity of SARS-CoV-2 infection (30), and should be encouraged. Whilst our cohort of women did not have severe symptoms of COVID-19, despite being unvaccinated, the lack of any associated placental pathology and the minimal changes observed in the number of placental immune cells indicates that mild maternal COVID-19 infection is unlikely to cause harm to the developing fetus.…”

Section: Poor Pregnancy Outcomes and Placental Pathologymentioning

confidence: 99%

Placental Macrophages Following Maternal SARS-CoV-2 Infection in Relation to Placental Pathology

Sharps¹,

Garrod²,

Aneni³

et al. 2022

Front.Virol.

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IntroductionIn December 2019, a novel coronavirus, SARS-CoV-2, was identified. Whilst pregnant women appear to be at risk of severe infection, pre-term birth, and stillbirth, it is unclear whether placental dysfunction is a consistent feature of maternal SARS-CoV-2 infection during pregnancy. We aim to describe the immune response in placentas of women who had COVID-19 infection during pregnancy and investigate whether there are any associated morphological changes.MethodsThe placentas of women testing positive for COVID-19 during their pregnancy were compared to contemporaneous controls who were not known to have had COVID-19 during pregnancy. Samples of each placenta were sent for histopathological analysis or underwent immunohistochemical staining for CD163, CD20, CD3, CD31, and SARS-CoV-2 spike protein. A subset of samples were sent for transmission electron microscopy.ResultsThere was a significant increase in the number of CD163+ macrophages in the Post COVID group (p = 0.0020). There was no difference in the percentage of CD3+, CD20+ cells, but there was an increase in placental vascularity in the Post COVID group compared to controls (p = 0.026).There were no structural differences observed between the samples sent for EM analysis. However, one of the placentas from the Post COVID group was seen to have several large sub-apical vacuoles in the syncytiotrophoblast. We did not observe any virions within the vacuoles and SARS-CoV-2 spike protein staining was negative for the sample. Histopathological investigations indicated that there was no specific placental pathology caused by maternal COVID-19 infection in this cohort of samples.ConclusionsThis study did not confirm previous studies which describe a possible increase in cases of both maternal and fetal vascular malperfusion, and placentitis in women who had COVID-19, which were seen in association with adverse pregnancy outcomes. It remains unclear whether observed abnormalities are caused by maternal infection, or whether maternal infection exacerbates existing placental pathology; understanding why some placentas generate these abnormalities is a key goal.

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Maternal Outcomes After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Vaccinated Compared With Unvaccinated Pregnant Patients

Cited by 77 publications

References 6 publications

Safety-Related Outcomes of Novel mRNA COVID-19 Vaccines in Pregnancy

Safety-Related Outcomes of Novel mRNA COVID-19 Vaccines in Pregnancy

SARS-CoV-2 Vaccines during Pregnancy and Breastfeeding: A Systematic Review of Maternal and Neonatal Outcomes

Placental Macrophages Following Maternal SARS-CoV-2 Infection in Relation to Placental Pathology

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