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Is the Immunization of Pregnant Women against COVID-19 Justified?

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Clinical course of novel COVID-19 infection in pregnant women

Roman G. Shmakov et al.

Summary: Most cases of COVID-19 in pregnant women are mild, but 9% are severe, which may lead to preterm delivery or increased maternal morbidity. Major predictors of severe COVID-19 in pregnant women include decreased levels of erythrocytes and lymphocytes, and increased levels of alanine aminotransferase and CRP. There is no evidence of vertical transmission, but this possibility cannot be excluded.

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Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves

Maria Elena Cavicchiolo et al.

Summary: This review summarizes all published papers related to neonatal COVID-19 management in Italy, providing useful insights for managing the mother-neonate dyad during future waves of SARS-CoV-2. Italian neonatologists have actively contributed to producing guidelines and data that have enhanced neonatal care in the pandemic. A joint European action plan is essential for increasing awareness and effectively addressing COVID-19 in neonates.

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Review Immunology

Pregnant women & vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response

Carleigh B. Krubiner et al.

Summary: Zika virus, influenza, and Ebola outbreaks have shed light on the unique impacts on pregnant women and their offspring, highlighting the need for proactive consideration in vaccine research and response efforts. The exclusion of pregnant women in research agendas and vaccine campaigns is unjust and problematic from a public health perspective. To address these issues, new approaches to public health preparedness and vaccine research are necessary.

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Vertical transmission of coronavirus disease 2019: a systematic review and meta-analysis

Alexander M. Kotlyar et al.

Summary: The study found that 3.2% of 936 neonates from mothers with coronavirus disease 2019 tested positive for severe acute respiratory syndrome coronavirus 2 viral RNA using nasopharyngeal swab. The rates of infection are similar to those of other pathogens causing congenital infections but further research is needed to determine the rates of vertical transmission in early pregnancy and potential risk for fetal morbidity and mortality.

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Epidemiology of coronavirus disease 2019 in pregnancy: risk factors and associations with adverse maternal and neonatal outcomes

Justin S. Brandt et al.

Summary: This study aimed to quantify the associations of coronavirus disease 2019 with adverse maternal and neonatal outcomes in pregnancy, showing that the disease is associated with an increased risk of adverse maternal and neonatal outcomes, primarily driven by morbidity associated with severe or critical coronavirus disease 2019. Major risk factors for associated morbidity were identified as black and Hispanic race, obesity, advanced maternal age, medical comorbidities, and antepartum admissions related to coronavirus disease 2019.

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Review Pediatrics

Coronavirus infection in neonates: a systematic review

Daniele Trevisanuto et al.

Summary: Most neonates with SARS-CoV-2 infection are asymptomatic or present mild symptoms, generally breathe spontaneously, and have a good prognosis after a median hospital stay of 10 days.

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The historical aspects of vaccination in pregnancy

David William Mackin et al.

Summary: Vaccines play a crucial role in pregnancy care and have improved outcomes for pregnant women and newborns through the evolution and application of new knowledge. Amidst the COVID-19 pandemic, history's lessons remind us to strengthen vaccination efforts for pregnant women to reduce morbidity for both mothers and infants.

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Infant Outcomes Following Maternal Infection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): First Report From the Pregnancy Coronavirus Outcomes Registry (PRIORITY) Study

Valerie J. Flaherman et al.

Summary: After analyzing data from a US registry of 263 infants, it was found that maternal SARS-CoV-2 infection did not have any significant impact on birth weight, respiratory issues, or respiratory infections in infants up to 8 weeks of age.

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Possible vertical transmission and antibodies against SARS-CoV-2 among infants born to mothers with COVID-19: A living systematic review

George M. Bwire et al.

Summary: The current evidence suggests low likelihood of vertical transmission of COVID-19, with antibodies against SARS-CoV-2 detected among vertically exposed but negative infants. Further studies on transplacental transmission and natural passive immunity in infants born to mothers with COVID-19 are needed.

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Managing Preterm Infants Born to COVID-19 Mothers: Evidence from a Retrospective Cohort Study in Wuhan, China

Xiaolin Hu et al.

Summary: Research has shown that the impact of COVID-19 mothers on preterm infants is limited, with most preterm babies achieving good short-term outcomes through appropriate management.

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Comprehensive analysis of COVID-19 during pregnancy

Kathryn M. Moore et al.

Summary: The impact of COVID-19 on pregnancy is still not well understood, but current research is focusing on the potential risks and complications that pregnant individuals may face when infected with SARS-CoV-2.

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SARS-Cov-2 in first trimester pregnancy: a cohort study

N. la Cour Freiesleben et al.

Summary: The study found that maternal infection with SARS-CoV-2 in the first trimester did not significantly affect nuchal translucency thickness or increase the risk of pregnancy loss. These results suggest that the virus may not pose a significant threat to pregnant women and their fetuses in the early stages of pregnancy.

HUMAN REPRODUCTION (2021)

Article Virology

Evaluation of maternal serum afamin and vitamin E levels in pregnant women with COVID-19 and its association with composite adverse perinatal outcomes

Seyit A. Erol et al.

Summary: This study evaluated the levels of maternal serum afamin and vitamin E in pregnant women with COVID-19 and their association with composite adverse perinatal outcomes. The COVID-19 group had a higher obstetric complication rate, higher afamin levels, and lower vitamin E levels. The results suggest that higher afamin and lower vitamin E levels may be related to increased oxidative stress in COVID-19 pathogenesis and adverse perinatal outcomes.

JOURNAL OF MEDICAL VIROLOGY (2021)

Review Oncology

Updates in neonatal coronavirus disease 2019: What can we learn from detailed case reports?

Xingchao Li et al.

Summary: This study conducted a literature search for detailed case reports on neonatal COVID-19 published as of July 15, 2020, to facilitate the clinical treatment, epidemic prevention, and control. A total of 40 nonoverlapping case reports were identified, providing information on demographic characteristics, transmission modes, clinical features, treatments, and prognosis of neonatal COVID-19.

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Article Obstetrics & Gynecology

Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study

Kathryn J. Gray et al.

Summary: The study found that pregnant and lactating women had equivalent antibody titers after receiving the coronavirus disease 2019 mRNA vaccine compared to nonpregnant women, and these titers were higher than those induced by natural infection. Vaccine-induced antibodies were present in umbilical cord blood and breastmilk samples, transferring immunity to neonates through placenta and breastmilk.

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY (2021)

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Cord blood antibodies following maternal coronavirus disease 2019 vaccination during pregnancy

Leena B. Mithal et al.

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Article Medicine, General & Internal

The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis

Shu Qin Wei et al.

Summary: Infection with COVID-19 during pregnancy may lead to an increased risk of preeclampsia, preterm birth, and other adverse pregnancy outcomes. Severe cases of COVID-19 are particularly associated with higher risks of complications such as preeclampsia, preterm birth, gestational diabetes, and low birth weight.

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Letter Medicine, General & Internal

SARS-CoV-2-Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women

Sivan Haia Perl et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

Article Medicine, General & Internal

Association of Maternal SARS-CoV-2 Infection in Pregnancy With Neonatal Outcomes

Mikael Norman et al.

Summary: In a nationwide cohort of infants in Sweden, maternal SARS-CoV-2 infection in pregnancy was significantly associated with small increases in some neonatal morbidities. Given the small numbers of events for many of the outcomes and the large number of statistical comparisons, the findings should be interpreted as exploratory.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

Article Medicine, General & Internal

Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women

Ai-ris Y. Collier et al.

Summary: This study assessed the immunogenicity of COVID-19 mRNA vaccines in pregnant and lactating women, as well as the responses against emerging SARS-CoV-2 variants. The results showed that pregnant, lactating, and nonpregnant women developed antibody and T-cell responses following vaccination, with antibodies transferred to infant cord blood and breast milk. While antibody titers against the B.1.1.7 and B.1.351 variants were reduced, T-cell responses remained against the viral variants.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

Article Medicine, General & Internal

Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons

Tom T. Shimabukuro et al.

Summary: Preliminary data indicates that there are no obvious safety signals among pregnant women who received mRNA Covid-19 vaccines, but more data is needed for further confirmation. Adverse reactions such as injection-site pain were reported more frequently in pregnant women, but most pregnancies resulted in live births with some cases of preterm birth and small size for gestational age.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Pediatrics

Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection The INTERCOVID Multinational Cohort Study

Jose Villar et al.

Summary: This study evaluated the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with pregnant individuals without COVID-19, finding that pregnant individuals with COVID-19 were at higher risk for various complications such as preeclampsia, severe infections, and preterm birth. The findings emphasize the importance for pregnant individuals and clinicians to strictly implement recommended COVID-19 preventive measures.

JAMA PEDIATRICS (2021)

Article Andrology

COVID-19 vaccine hesitancy linked to increased internet search queries for side effects on fertility potential in the initial rollout phase following Emergency Use Authorization

Parris Diaz et al.

Summary: The study found that there was a significant increase in online queries related to fertility following the Emergency Use Authorization of the COVID-19 vaccine, which may be a major factor contributing to vaccine hesitancy.

ANDROLOGIA (2021)

Article Obstetrics & Gynecology

Ovarian follicular function is not altered by SARS-CoV-2 infection or BNTI62b2 mRNA COVID-19 vaccination

Y. Bentov et al.

Summary: This study demonstrated that antibodies produced after COVID-19 infection or vaccination can be detected in follicular fluid without impacting follicular function. Despite the limitations of being a small-scale study, these initial findings suggest that SARS-CoV-2 infection and COVID-19 vaccination do not have measurable detrimental effects on ovarian follicle function.

HUMAN REPRODUCTION (2021)

Review Medicine, General & Internal

The impact of COVID-19 in pregnancy: Part II. Vaccination to pregnant women

Peng-Hui Wang et al.

Summary: Pregnant women with COVID-19 infection are at high risk of adverse outcomes. Vaccination is proven to be a safe and effective strategy, however, exclusion of pregnant and lactating women from vaccine trials has led to uncertainty around safety and efficacy, contributing to vaccine hesitancy among pregnant women.

JOURNAL OF THE CHINESE MEDICAL ASSOCIATION (2021)

Article Public, Environmental & Occupational Health

Breastfeeding in Mothers with COVID-19: Insights from Laboratory Tests and Follow-Up from Early Outbreak of the Pandemic in China

Qing-Qing Luo et al.

Summary: Research on mothers infected with COVID-19 showed no detection of the virus in breast milk, suggesting the safety of breastfeeding for newborns. The rate of breastfeeding increased in two follow-ups, while mothers' psychological status gradually became more positive.

JOURNAL OF WOMENS HEALTH (2021)

Letter Medicine, General & Internal

SARS-CoV-2 vaccination in pregnancy: a unique opportunity for equity

Erkan Kalafat et al.

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COVID-19 in Pregnancy: A Current Review of Global Cases

Sung Y. Chae et al.

Summary: Pregnant women generally experience COVID-19 as a mild to moderate illness, with a small percentage becoming critically ill. Newborns usually have favorable outcomes, but infection control measures are necessary to prevent transmission during the peripartum period.

OBSTETRICAL & GYNECOLOGICAL SURVEY (2021)

Article Immunology

Efficient Maternal to Neonate Transfer of Neutralizing Antibodies after SARS-CoV-2 Vaccination with BNT162b2: A Case-Report and Discussion of the Literature

Jonathan Douxfils et al.

Summary: The successful transfer of neutralizing antibodies from a pregnant woman to her fetus after vaccination suggests that these antibodies have specific characteristics related to their neutralizing capacity. Vaccination against COVID-19 in pregnancy is important for controlling disease burden and improving outcomes in both the mother and the fetus. Including pregnant women in research programs for vaccine development is crucial to ensure equitable benefits for this population.

VACCINES (2021)

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COVID-19 Vaccine in Pregnant and Lactating Women: A Review of Existing Evidence and Practice Guidelines

Ishan Garg et al.

Summary: The global COVID-19 pandemic has had devastating impacts, but multiple vaccines have been developed at an unprecedented speed. Despite pregnant and lactating women being excluded from vaccine trials, healthcare professional advisory committees have issued guidance supporting COVID-19 vaccination based on prior experience and preliminary studies.

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Joint IFFS/ESHRE statement on COVID-19 vaccination for pregnant women and those considering pregnancy

Steven Ory et al.

HUMAN REPRODUCTION OPEN (2021)

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Comparison of VEGF-A values between pregnant women with COVID-19 and healthy pregnancies and its association with composite adverse outcomes

Nuray Yazihan et al.

Summary: The study compared VEGF-A values between pregnant women with COVID-19 and healthy controls, as well as their association with inflammation parameters, disease severity, and obstetric complications. The results showed similar serum VEGF-A levels between the two groups, but a higher rate of obstetric complications in the COVID-19 group.

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Clinical course of coronavirus disease-2019 in pregnancy

Augusto Pereira et al.

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Clinical characteristics of 46 pregnant women with a severe acute respiratory syndrome coronavirus 2 infection in Washington State

Erica M. Lokken et al.

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Coronavirus disease 2019 in pregnant women: a report based on 116 cases

Jie Yan et al.

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Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection

Maksim Kirtsman et al.

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Andrea Carosso et al.

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Analysis of vaginal delivery outcomes among pregnant women in Wuhan, China during the COVID-19 pandemic

Jing Liao et al.

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Detection of SARS-CoV-2 in Different Types of Clinical Specimens

Wenling Wang et al.

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Hui Yang et al.

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Rüdiger Groß et al.

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Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth

Loic Sentilhes et al.

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Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study

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Oscar Martinez-Perez et al.

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Biheng Cheng et al.

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Gilles Kayem et al.

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Mia Ahlberg et al.

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