怀孕期的结果和疫苗的有效性作为令人担忧的变种,INTERCOVID-2022:一项跨国观察性研究
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
概括
怀孕期间的COVID-19,特别是Omicron变种,增加了母亲和新生儿的风险. 疫苗接种显著减少了严重的结局,突出了孕妇疫苗接种范围的重要性.
科学领域:
- 产科和妇科
- 传染性疾病
- 公共卫生
背景情况:
- 之前的研究表明怀孕期间COVID-19的风险增加.
- 由于SARS-CoV-2病毒已经进化,因此需要对孕妇进行最新的风险评估.
- 欧米克朗 (B.1.1.529) 变种成为主导菌株,促使对其特定影响进行评估.
研究的目的:
- 评估COVID-19在怀孕期间对孕产妇和产后结果的影响.
- 评估COVID-19疫苗在孕妇中对Omicron变种的有效性.
- 分析与有症状和未接种疫苗的孕妇相关的风险.
主要方法:
- 一项大规模的前性观察性研究 (INTERCOVID-2022),涉及18个国家的41家医院.
- 确诊COVID-19的孕妇与没有COVID-19的两个对照组进行比较.
- 主要结局包括孕产妇发病率和死亡率指数 (MMMI),重症新生儿发病率指数 (SNMI) 和重症周围发病率和死亡率指数 (SPMMI).
主要成果:
- 患有COVID-19的孕妇出现MMMI (RR 1.16) 和SPMMI (RR 1.21) 的风险增加.
- 诊断为COVID-19的未接种疫苗的妇女患MMMI的风险更高 (RR为1.36).
- 疫苗在完整的治疗方案中有效率为48%,增加到76%以预防严重并发症.
结论:
- 怀孕期间的COVID-19,尤其是Omicron变种,对严重的孕产妇和产前疾病和死亡造成重大风险.
- 接种疫苗,特别是用增剂接种疫苗,大大降低了孕妇患COVID-19严重并发症的风险.
- 在孕妇中优先接种疫苗对于减轻不良后果至关重要.
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