COVID-19 vaccines in pregnancy

Nunes, Marta C; Madhi, Shabir A.

doi:10.1016/j.molmed.2022.04.012

Cited by 20 publications

(29 citation statements)

References 87 publications

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“…In our cohort of 81 pregnant women ∼40% were non-caucasian, affording high robustness to the results obtained as immune responses can differ in distinct population groups due to host genetic factors, differences in the prevalence of comorbidities, and/or differences in the efficiency of transplacental antibody transfer to the fetus (37). We are aware that the vaccinated group is ethnically more homogeneous than the SARS-CoV-2 + cohort.…”

Section: Discussionmentioning

confidence: 83%

Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection

Gonçalves

Melro

Alenquer

et al. 2022

Preprint

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Maternal immune responses during pregnancy protect the growing fetus by clearing infection, preventing its vertical transmission, and through transplacental transfer of protective immune mediators to the fetus. How maternal immune response balances SARS-CoV-2 antiviral responses with transplacental transfer of protection to the fetus remains unclear. Our study shows that upon SARS-CoV-2 maternal infection, neutralizing antibodies (NAbs) are infrequently detected in cord blood. We uncovered that this is due to impaired IgG-NAbs placental transfer in symptomatic infection and to the predominance of maternal SARS-CoV-2 NAbs of the IgA and IgM isotypes, which are prevented from crossing the placenta. Crucially, the decision between favoring maternal antiviral response or transplacental transfer of immune protection to the fetus appears to hinge on the balance between IL-6 and IL-10 induced by SARS-CoV-2 infection, decreasing or increasing transplacental transfer of IgG-NAbs, respectively. In addition, IL-10 inversely correlates with maternal NK cell frequency. Finally, we found that ongoing infection favored perinatal transfer of maternal NK cells, highlighting a maternal sponsored mechanism to protect the newborn from horizontal transmission of infection. Our data point to an evolutionary trade-off which at once optimizes maternal viral clearance and vertical transfer of immune protection during the more susceptible perinatal period.

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Section: Discussionmentioning

confidence: 83%

Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection

Gonçalves

Melro

Alenquer

et al. 2022

Preprint

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“…Meanwhile, the titers of RBD-specific IgG, neutralizing antibodies, and T cytokine levels (especially the IFN-γ levels) are adopted as the indicators to determine whether the vaccine induced an effective humoral and cellular immune response in the host ( 44 ). The effectiveness of COVID-19 vaccines has been evaluated in healthy adults ( 45 ), immunocompromised patients ( 46 ), adolescents and children ( 47 , 48 ), pregnant women ( 49 ), and cancer patients ( 50 ). The evaluation results showed that vaccination has distinct degrees of immune protection in all populations.…”

Section: Discussionmentioning

confidence: 99%

Publication trends of research on COVID-19 and host immune response: A bibliometric analysis

Xia

Yao

Zhao

et al. 2022

Front. Public Health

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IntroductionAs the first bibliometric analysis of COVID-19 and immune responses, this study will provide a comprehensive overview of the latest research advances. We attempt to summarize the scientific productivity and cooperation across countries and institutions using the bibliometric methodology. Meanwhile, using clustering analysis of keywords, we revealed the evolution of research hotspots and predicted future research focuses, thereby providing valuable information for the follow-up studies.MethodsWe selected publications on COVID-19 and immune response using our pre-designed search strategy. Web of Science was applied to screen the eligible publications for subsequent bibliometric analyses. GraphPad Prism 8.0, VOSviewer, and CiteSpace were applied to analyze the research trends and compared the contributions of countries, authors, institutions, and journals to the global publications in this field.ResultsWe identified 2,200 publications on COVID-19 and immune response published between December 1, 2019, and April 25, 2022, with a total of 3,154 citations. The United States (611), China (353), and Germany (209) ranked the top three in terms of the number of publications, accounting for 53.3% of the total articles. Among the top 15 institutions publishing articles in this area, four were from France, four were from the United States, and three were from China. The journal Frontiers in Immunology published the most articles (178) related to COVID-19 and immune response. Alessandro Sette (31 publications) from the United States were the most productive and influential scholar in this field, whose publications with the most citation frequency (3,633). Furthermore, the development and evaluation of vaccines might become a hotspot in relevant scope.ConclusionsThe United States makes the most indispensable contribution in this field in terms of publication numbers, total citations, and H-index. Although publications from China also take the lead regarding quality and quantity, their international cooperation and preclinical research need to be further strengthened. Regarding the citation frequency and the total number of published articles, the latest research progress might be tracked in the top-ranking journals in this field. By analyzing the chronological order of the appearance of retrieved keywords, we speculated that vaccine-related research might be the novel focus in this field.

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“…This study was conducted before COVID-19 vaccines were available in the country; however, COVID-19 vaccines induce good immune responses in pregnant women, with efficient transplacental transfer of antibodies and protect the women and their infants against COVID-19. 16 Given the evolving nature of this virus, longitudinal follow-ups and evaluations after infection with different viral strains will be needed to assess the full impact of these infections on maternal, fetal, and neonatal outcome.…”

Section: Discussionmentioning

confidence: 99%

Active Intrapartum SARS-CoV-2 Infection and Pregnancy Outcomes

et al. 2022

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Objective Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy has been associated with poor pregnancy outcomes. There is, however, not much information on the impact of the timing of SARS-CoV-2 infection on pregnancy outcomes, and studies from low-middle income settings are also scarce. Study Design We conducted a cross-sectional study from April to December 2020, in South Africa, to assess the association of SARS-CoV-2 infection on a nasal swab at the time of labor with fetal death, preterm birth, low birth weight, or pregnancy-induced complications. When possible, maternal blood, cord blood, and placenta were collected. SARS-CoV-2 infection was investigated by a nucleic acid amplification test (NAAT). Results Overall, 3,117 women were tested for SARS-CoV-2 on a nasal swab, including 1,562 (50%) healthy women with uncomplicated term delivery. A positive NAAT was detected among 132 (4%) women. Adverse birth outcomes or pregnancy-related complications were not associated with SARS-CoV-2 infection at the time of labor. Among SARS-CoV-2-infected women, an NAAT-positive result was also obtained from 6 out of 98 (6%) maternal blood samples, 8 out of 93 (9%) cord-blood samples, 14 out of 54 (26%) placentas, and 3 out of 22 (14%) nasopharyngeal swabs from newborns collected within 72 hours of birth. Histological assessment of placental tissue revealed that women with SARS-CoV-2 nasal infection had a higher odds (3.82, 95% confidence interval: 1.20, 12.19) of chronic chorioamnionitis compared with those without SARS-CoV-2 infection. Conclusion Our study demonstrates that intrapartum, SARS-CoV-2 infection was not associated with evaluated poor outcomes. In utero fetal and placental infections and possible vertical and/or horizontal viral transfer to the newborn were detected among women with nasal SARS-CoV-2 infection. Key Points

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COVID-19 vaccines in pregnancy

Cited by 20 publications

References 87 publications

Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection

Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection

Publication trends of research on COVID-19 and host immune response: A bibliometric analysis

Active Intrapartum SARS-CoV-2 Infection and Pregnancy Outcomes

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