New commentary published as “Impress Preview” in Journal of Clinical ResearchAddresses important issues regarding the potential for vaccination against coronavirus disease (COVID-19) during pregnancy and antibody transfer to the fetus, and the safety and efficacy of messenger RNA (mRNA) vaccines for maternal and child health. Provide supporting evidence.
Pregnancy makes women more susceptible to potential complications caused by a variety of pathogens, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of ongoing COVID-19 pandemics. It is characterized by significant changes in the immune and endocrine systems.
More specifically, pregnant women are three times more likely to be admitted to the intensive care unit after infection and require ventilator support or extracorporeal oxygenation, but compared to uninfected pregnant women. Then you are more likely to get sick.
Similarly, various obstetric complications (especially preterm birth) occur more frequently when the mother is infected with SARS-CoV-2. Therefore, both mother and newborn health problems are more likely to be prolonged.
COVID-19 vaccine and pregnancy
Nevertheless, due to new technology and (at that time) uncertainty Efficacy of Pregnant volunteers were initially excluded from clinical trials with the mRNA vaccine against COVID-19. Given the above effects of COVID-19 on pregnant women, many organizations and societies have begun to recommend the administration of these vaccines during pregnancy.
At this time, there is evidence-based consensus that the COVID-19 vaccine does not cause infertility in either women or men. In addition, when administered during pregnancy, mRNA fragments from the vaccine do not cross the placenta, are consumed by muscle cells at the injection site, and are degraded after the synthesis of the encoded protein.
However, while reassuring, data on pregnancy and fetal transplantation are still limited. This is why a research group led by Dr. Ofer Beharie of the Hebrew University of Jerusalem Medical Center has decided to evaluate the maternal and neonatal response to the Pfizer BNT162b2 SARS-CoV-2 mRNA vaccine.
Multicenter study in Israel
In this multicenter study, researchers surveyed a cohort of 1,094 participants from eight Israeli hospitals. Pregnant women with maternal COVID-19 disease at birth were excluded from the study, but the eligibility criteria were 18 years (or older) and stated that they would be willing to participate if they had informed consent. ..
Blood samples from women and cord blood samples from newborns were collected between April 2020 and March 2021. The sample was centrifuged at room temperature (1000 g for 10 minutes), the serum was dispensed and placed in a dedicated corded tube. Finally, the sample was stored at -80 ° C until analysis.
All study participants were assigned to three groups: vaccinated, previously unvaccinated who tested positive for SARS-CoV-2, and previously unvaccinated. I did. The titers of IgG and IgM antibodies from serum were measured using the Milliplex MAP SARS-CoV-2 Antigen Panel.
Firmly protects mother and child
This study shows a steady increase in maternal IgG humoral response to various components of SARS-CoV-2 spikes. Glycoprotein Non-infected patients who are vaccinated.These immunoglobulins were easily transferred to the foetation via the placenta, leading to substantial anti-SARS-CoV-2. Antibody titer In the bloodstream of newborns within 14 days of the first vaccination.
In addition, women who recovered from SARS-CoV-2 infection during the second trimester of pregnancy (13-26 weeks gestation) remained high in anti-COVID-19 antibodies in maternal and cord blood samples at birth.
Compared to natural infections, vaccination produces strong protective antibodies in women and successfully transfers to the foetation during pregnancy. Importantly, none of the vaccine-inducing antigens showed evidence of a fetal IgM response. This means that there was no direct exposure of the foetation to the vaccine-inducing antigen.
Implications and future research
Due to the significant burden of COVID-19 on pregnant mothers, vaccination should be considered at any time during pregnancy for the health of pregnant women. However, vaccination of previously infected pregnant women should be based on titer testing.
Vaccination during early pregnancy can reduce the efficiency of antibody transfer from mother to fetus, but vaccination during pregnancy clearly provides separate benefits for mother and mother, so vaccination at any time during pregnancy Is not a reason to support. Foetation.
In any case, we are dealing with vulnerable people and we need to further strengthen the public health efforts behind this concept. Further research is needed to address this issue further, as ethnicity and race can affect the adverse effects of SARS-Cov2 infection on pregnancy.
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