Pregnant women's perspectives on severe acute respiratory syndrome coronavirus 2 vaccine

Carbone, Luigi; Mappa, Ilenia; Sirico, Angelo; Girolamo, Raffaella Di; Saccone, Gabriele; Mascio, Daniele Di; Donadono, V.; Cuomo, Lara; Gabrielli, Olimpia; Migliorini, Sonia; Luviso, Maria; D’Antonio, F.; Rizzo, Giuseppe; Maruotti, Giuseppe Maria

doi:10.1016/j.ajogmf.2021.100352

Cited by 54 publications

(63 citation statements)

References 29 publications

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“…Recent studies showed that the COVID-19 vaccine does not cause additional adverse effects in pregnant or lactating women [ 41 , 42 ]. However, surveys showed that only 28.2% of pregnant women in Italy were willing to get vaccinated [ 43 ]. This finding is in agreement with the observation that the scientific-sounding misinformation appears to be associated with the decline of the COVID-19 vaccine [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China

Gao

Zhang

et al. 2021

Vaccines

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Surveys showed that vaccine hesitancy may influence the acceptance of COVID-19 vaccines in healthcare workers (HCWs) and the general population. Currently, the actual acceptance of COVID-19 vaccination in HCWs has rarely been reported. In the present survey, we investigated the real-world acceptance of COVID-19 vaccination in HCWs in perinatal medicine during the first three-month period of vaccination in China and to identify the main reason for the decline of vaccination. HCWs (1087) who participated in a Chinese national symposium on perinatal medicine during 16–18 April 2021 were invited to answer a 27-question questionnaire online. A total of 1051 HCWs completed the questionnaire. Of them, 86.2% (906/1051) accepted the COVID-19 vaccination and 13.8% (145/1051) declined the vaccination. Because of the vaccine hesitancy, one-fourth of the vaccinated participants did not accept the vaccination until consulted with others or requested by employers. The main reason for the decline of vaccination in 145 unvaccinated HCWs was the concern about vaccine safety. The results indicate that vaccination request by employers may promote vaccine acceptance. More convincing data on the safety of COVID-19 vaccines appears to be important to increase the acceptance of vaccination.

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Section: Discussionmentioning

confidence: 99%

Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China

Gao

Zhang

et al. 2021

Vaccines

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“… 2 , 3 , 4 , 5 Currently, although vaccinal programs are opened to pregnant women, there are still reports of a poor acceptance rate in this category of patients. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5] Currently, although vaccinal programs are opened to pregnant women, there are still reports of a poor acceptance rate in this category of patients. 6,7 Indeed, SARS-CoV-2 infection has been reported to potentially affect the placenta. 8 Several reports suggest an increased risk of placental lesions due to hypoperfusion and inflammation in women with SARS-CoV-2 infection.…”

Section: Introductionmentioning

confidence: 99%

Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis

Girolamo

Khalil

Alameddine

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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115

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Objectives : To report the spectrum of placental pathology findings in pregnancies complicated by SARS-CoV-2 infection. Methods : MEDLINE, EMBASE, Google Scholar and the Web of Science databases were searched up to August 11 th , 2021. Histopathological anomalies included maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), acute inflammatory pathology (AIP), chronic inflammatory pathology (CIP), increased perivillous fibrin and intervillous thrombosis. Sub-analyses including only symptomatic women and high-risk pregnancies were also performed. Histopathological analysis of the placenta included gross examination, histopathology on hematoxylin and eosin (H&E), immunohistochemistry (IHC), fluorescence in-situ hybridization (FISH), qRT-PCR on placental tissue, and transmission electron microscope (TEM). Random-effect meta-analyses were used to analyze the data. Results : Fifty-seven studies (1009 pregnancies) were included. MVM was reported in 31.4% (95% CI 21.0-42.8) of placentas, while FVM was observed in 26.9% of cases (95% CI 19.2-35.4). AIP and CIP were reported in 22.6% (95% CI 16.8-28.9) and 26.2% (95% CI 18.9-34.2) of cases, respectively. Increased perivillous fibrin was observed in 32.7% (95% CI 24.1-42.0) of placentas undergoing histopathological analysis, while intervillous thrombosis were observed in 14.6% (95% CI 10.6-21.8) of cases. Other placental findings, including either basal plate with attached myometrial fibers, microscopic accretism, villous edema, increased circulating nucleated Red Blood Cells or membranes with hemorrhage were reported in 38% (95% CI 28.5-48.0) of cases, while only 17.4% (95% CI 10.9-25.0) did not present any abnormal histological findings. Sub-analyses according to maternal symptoms due to SARS-CoV-2 infection or the presence of a high-risk pregnancy showed similar distribution of the different histopathological anomalies to that reported in the main analysis. The risk of placental histopathological anomalies was also higher when considering only case-control studies comparing women with SARS-CoV-2 infection with healthy controls. Conclusions : A significant proportion of placentas where SARS-CoV-2 occurred during pregnancy shows histopathological findings suggesting placental hypoperfusion and inflammation. Future multicenter prospective blinded studies are needed to correlate these placental lesions with pregnancy outcomes.

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“…This goal should be quickly reached, providing adequate information to the population on how to follow strict rules to seek hospital assistance, if and only a problem arises. Vaccines against SARS-COV-2 have now been produced and released; national societies recommend their use in pregnant women, [ 32 , 33 ] although preliminary reports show patients’ fear for eventual adverse events and safety concerns for the fetus [ 34 , 35 ]. Indeed, their diffusion will hopefully reduce the burden of the pandemic and consequently the impact on healthcare systems.…”

Section: Discussionmentioning

confidence: 99%

Obstetric A&E unit admission and hospitalization for obstetrical management during COVID-19 pandemic in a third-level hospital of southern Italy

Carbone

Raffone

Travaglino

et al. 2021

Arch Gynecol Obstet

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Background The COronaVIrus Disease 2019 (COVID-19) has spread in Italy since February 2020, inducing the government to call for lockdown of any activity, apart primary needs, during the months March–May 2020. During the lockdown, a reduction of admissions and hospitalizations for ischemic diseases was noticed. Purpose of this study was to observe if there has been the same reduction trend in Accident & Emergency (A&E) unit admissions also for obstetric-gynecological conditions. Methods Medical records and electronic clinical databases were searched for all patients who were admitted to the obstetric A&E department or hospitalized at the Gynecology and Obstetrics Unit of University hospital of Naples Federico II, during the quarter March–May in the years 2019 and 2020. The mean ± standard deviation (SD) of monthly admission to the obstetric A&E department and hospitalization of the year 2020 was compared with that of the year 2019, using the unpaired T test with α error set to 0.05 and 95% confidence intervals (95% CI). Results Admissions were 1483 in the year 2020 and 1786 in 2019. Of total, 1225 (37.5%) women were hospitalized: 583 in the year 2020, 642 in 2019. Mean ± SD of patients monthly admitted to our obstetric A&E department was 494 ± 33.7 in the year 2020, and 595.3 ± 30.9 in 2019, with a mean difference of − 101.3 (95% CI − 103.5 to − 99.1; p < 0.0001). Mean ± SD of patients monthly hospitalized to our department was 194 ± 19.1 in the year 2020, 213.7 ± 4.7 in 2019, with a mean difference of − 19.7 (95% CI − 23.8 to − 15.6; p < 0.0001). Conclusion A significant decrease in the mean of monthly admissions and hospitalizations during the COVID-19 pandemic when compared to the previous year was found also for obstetric–gynecological conditions. Further studies are necessary to assess COVID-19 impact and to take the most appropriate countermeasures.

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Pregnant women's perspectives on severe acute respiratory syndrome coronavirus 2 vaccine

Cited by 54 publications

References 29 publications

Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China

Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China

Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis

Obstetric A&E unit admission and hospitalization for obstetrical management during COVID-19 pandemic in a third-level hospital of southern Italy

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