The impact of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes

Piekos, Samantha N.; Price, Nathan D.; Hood, Leroy; Hadlock, Jennifer

doi:10.1016/j.reprotox.2022.10.003

Cited by 12 publications

(18 citation statements)

References 113 publications

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“…COVID-19 during human pregnancy is associated with adverse pregnancy and fetal outcomes including preterm birth, stillbirth, small size for gestational age, and reduced birth weight (7). To evaluate if the maSCV2-induced maternal morbidity and placental damage observed after infection at E16 was associated with adverse pregnancy or fetal outcomes, we inoculated dams with maSCV2 or media at E6, E10, or E16, with a subset of dams euthanized at 3 dpi to evaluate fetal viability and the remainder followed to evaluate birth outcomes.…”

Section: Resultsmentioning

confidence: 99%

Section: Sars-cov-2 Infection Late In Gestation Causes Intrauterine G...mentioning

confidence: 99%

“…In addition to causing severe outcomes in pregnant patients, SARS-CoV-2 infection during pregnancy also can result in adverse fetal outcomes including preterm birth, stillbirth, small size for gestational age, and reduced birth weight (7), as well as increased risks of neurobehavioral deficits and delayed motor skills in infants born to infected mothers (8). Like maternal disease, adverse perinatal and fetal outcomes appear to be influenced by gestational age, with greater risk observed after infection in the third as compared with either the second or first trimester (3, 8, 9).…”

Section: Introductionmentioning

confidence: 99%

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Adverse outcomes in SARS-CoV-2 infected pregnant mice are gestational age-dependent and resolve with antiviral treatment

Creisher

Perry

Zhong

et al. 2023

Preprint

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SARS-CoV-2 infection during pregnancy is associated with severe COVID-19 and adverse fetal outcomes, but the underlying mechanisms remain poorly understood. Moreover, clinical studies assessing therapeutics against SARS-CoV-2 in pregnancy are limited. To address these gaps, we developed a mouse model of SARS-CoV-2 infection during pregnancy. Outbred CD1 mice were infected at embryonic day (E) 6, E10, or E16 with a mouse adapted SARS-CoV-2 (maSCV2) virus. Outcomes were gestational age-dependent with greater morbidity, reduced pulmonary function, reduced anti-viral immunity, greater viral titers, and more adverse fetal outcomes occurring with infection at E16 (3rd trimester-equivalent) than with infection at either E6 (1st trimester-equivalent) or E10 (2nd trimester-equivalent). To assess the efficacy of ritonavir-boosted nirmatrelvir (recommended for pregnant individuals with COVID-19), we treated E16-infected dams with mouse equivalent doses of nirmatrelvir and ritonavir. Treatment reduced pulmonary viral titers, decreased maternal morbidity, and prevented adverse offspring outcomes. Our results highlight that severe COVID-19 during pregnancy and adverse fetal outcomes are associated with heightened virus replication in maternal lungs. Ritonavir-boosted nirmatrelvir mitigated adverse maternal and fetal outcomes of SARS-CoV-2 infection. These findings prompt the need for further consideration of pregnancy in preclinical and clinical studies of therapeutics against viral infections.

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Section: Resultsmentioning

confidence: 99%

Section: Sars-cov-2 Infection Late In Gestation Causes Intrauterine G...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adverse outcomes in SARS-CoV-2 infected pregnant mice are gestational age-dependent and resolve with antiviral treatment

Creisher

Perry

Zhong

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite its safety, mothers are hesitant [14], and data on the durability of the immune response in pregnant women and the M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n 9 SARS-CoV2 variants [3,6]. Several studies in the literature demonstrated the safety of the BNT162b2 second-and third-dose vaccines in pregnancy in terms of early adverse events and immunogenicity, as well as the absence of early obstetric complications [16,17,18]. However, the immune response during pregnancy was reported to be lower than in non-pregnant women.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 booster vaccination in the current pregnancy during the Omicron waves on maternal and perinatal outcomes: a multicentre observational study

Kammoun¹,

Jarraya²,

Ellouze³

et al. 2023

Ital J Gynaecol Obstet

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Material and Methods. This was an observational multicenter study. Pregnant women who gave birth while infected by SARS CoV2 during the Omicron waves were included. Patients were divided into 2 groups: the "booster vaccination" group included pregnant women who had completed vaccination and had received an additional dose of vaccine during pregnancy; the "non-booster vaccination" group included pregnant women who had completed primary vaccination without booster shots. Data about obstetrical and neonatal outcomes in both groups were compared.Results. In total, 59 patients were included: 41 received booster shots during the current pregnancy, and 18 did not. Asymptomatic forms were seen in 58.5% of the "booster vaccination" group versus 16.6% of the "non-boosted vaccination" group with p = 0.003. The need for cesarean delivery was reduced from 72.2% to 41.4% with p = 0.028. The length of hospitalization was reduced from 4.67 ± 4 days in the "non-boosted vaccination" group to 1.98 ± 0.93 days in the booster vaccination group with p = 0.001. The booster vaccination allowed reduced rates of prematurity with p = 0.011 and neonatal intensive care admissions with p = 0.007. Conclusions.The COVID-19 booster vaccination seems to be beneficial during the Omicron waves. It improved obstetrical and neonatal outcomes. So, pregnant women could be advised to get a booster dose of the COVID-19 vaccine when they get pregnant.

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“…Despite the fact that vaccination did not offer full protection against SARS-CoV-2 and the infection and the occurrence of high rates of hesitation (particularly due to the uncertain influence on the fetus and the woman’s future fertility), promising results have been reported regarding vaccine effectiveness [ 21 , 22 , 23 ]. In addition, prevention of hospitalization was reported in vaccinated pregnant patients, with no additional pregnancy-related risks [ 22 , 24 , 25 , 26 , 27 , 28 ]. All over the world, 120 countries have recommended COVID-19 vaccine in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Outcomes in SARS-CoV-2-Positive Patients: A 20-Month Retrospective Analysis of Delivery Cases

et al. 2023

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Background and Objectives: The SARS-CoV-2 infection brings supplemental risks for pregnant women. Due to controversial hesitancy, their vaccination rate was lower in 2021 compared to the general population. In addition, access to maternal care was reduced during the pandemic. We conducted a retrospective cross-sectional analysis of the health records data over 20 months (1 April 2020 to 20 November 2021) aiming to explore the outcomes in SARS-CoV-2-positive cases referred for delivery to a tertiary public hospital in Western Romania. Materials and Methods: Women with SARS-CoV-2 infection diagnosed for the first time at the moment of birth who delivered singletons after 24 weeks of gestation, and had a clear immunization status were included in the analysis. Results: Out of the 97 patients included in the study, 35 (36%) had undergone ARN-based vaccination. Five cases of maternal death were recorded (all unvaccinated). Our retrospective exploratory analysis showed that the presence of COVID-19 symptoms in the SARS-CoV-2-positive patients made a significant impact on the delivery hospitalization, with a median hospital stay increase from 5 to 9 days (Mann–Whitney test, p = 0.014): longer hospitalization was recorded in the symptomatic cases irrespective of their vaccination status. No other adverse outcomes, such as gestational age at delivery, C-section rate, 5 min Apgar index, or birth weight were associated with the presence of symptoms. Conclusions: Our clinic maintained safe maternal care for the COVID-19 patients during the analyzed period. Vaccination of the expectant women was beneficial in SARS-CoV-2-positive patients by lowering the risk of COVID-19 symptoms, with subsequent implications on the newborns’ health and maternal attachment.

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The impact of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes

Cited by 12 publications

References 113 publications

Adverse outcomes in SARS-CoV-2 infected pregnant mice are gestational age-dependent and resolve with antiviral treatment

Adverse outcomes in SARS-CoV-2 infected pregnant mice are gestational age-dependent and resolve with antiviral treatment

The impact of COVID-19 booster vaccination in the current pregnancy during the Omicron waves on maternal and perinatal outcomes: a multicentre observational study

Pregnancy Outcomes in SARS-CoV-2-Positive Patients: A 20-Month Retrospective Analysis of Delivery Cases

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