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Resultados del embarazo y eficacia de la vacuna durante el período de omicron como la variante de preocupación,
Jose Villar1, Constanza P Soto Conti2, Robert B Gunier3
1Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
Lancet (London, England)
|January 20, 2023
Resumen
COVID-19 durante el embarazo, particularmente la variante Omicron, aumentó los riesgos para las madres y los recién nacidos. La vacunación redujo significativamente los resultados graves, lo que pone de relieve la importancia de la cobertura de la vacuna en las poblaciones embarazadas.
Área de la Ciencia:
- Obstetricia y ginecología
- Enfermedades infecciosas
- Salud pública
Sus antecedentes:
- Investigaciones anteriores indicaron un mayor riesgo de COVID-19 en el embarazo.
- El virus SARS-CoV-2 ha evolucionado, lo que requiere evaluaciones de riesgo actualizadas para las personas embarazadas.
- La variante Omicron (B.1.1.529) se convirtió en la cepa dominante, lo que provocó una evaluación de su impacto específico.
Objetivo del estudio:
- Evaluar los efectos del COVID-19 en los resultados maternos y perinatales durante el embarazo.
- Evaluar la efectividad de la vacunación contra el COVID-19 en mujeres embarazadas contra la variante Omicron.
- Analizar los riesgos asociados con las mujeres embarazadas sintomáticas y no vacunadas.
Principales métodos:
- Un gran estudio prospectivo y observacional (INTERCOVID-2022) en el que participaron 41 hospitales de 18 países.
- Comparación de mujeres embarazadas con COVID-19 confirmado contra dos grupos de control sin COVID-19.
- Los resultados primarios incluyeron el índice de morbilidad y mortalidad materna (MMMI), el índice de morbilidad neonatal grave (SNMI) y el índice de morbilidad y mortalidad perinatal grave (SPMMI).
Principales resultados:
- Las mujeres embarazadas con COVID-19 mostraron un mayor riesgo de MMMI (RR 1.16) y SPMMI (RR 1.21).
- Las mujeres no vacunadas con diagnóstico de COVID-19 tenían un mayor riesgo de MMMI (RR 1.36).
- La eficacia de la vacuna para los regímenes completos fue del 48%, aumentando al 76% con una dosis de refuerzo para prevenir complicaciones graves.
Conclusiones:
- COVID-19 durante el embarazo, especialmente con la variante Omicron, plantea riesgos significativos para la morbilidad y mortalidad materna y perinatal graves.
- La vacunación, especialmente con una dosis de refuerzo, reduce sustancialmente el riesgo de complicaciones graves de COVID-19 en las mujeres embarazadas.
- Dar prioridad a la cobertura de la vacunación entre las mujeres embarazadas es crucial para mitigar los resultados adversos.
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