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1.
Die Gynäkologie ; 55(9):654-659, 2022.
Article in German | Web of Science | ID: covidwho-2014084

ABSTRACT

Vaccinations are one of the greatest achievements for protecting public health. Vaccines given to pregnant women protect not only the pregnant woman, but also the newborn. Pregnant women are disproportionately strongly affected by infections. The conflicting demands on the maternal immune system during pregnancy geared toward maintaining fetal immune tolerance make a rapid and effective immune response against pathogens more difficult. This dynamic state of immune adaptation predisposes pregnant women to more severe disease progression. Vaccination can prevent infection or a serious course of disease. As a result, the risk of premature birth and other serious pregnancy complications that can have lifelong consequences for both mother and child also decreases. After birth, when the newborn must first develop an adaptive memory for a hitherto unknown, antigen-rich environment, it is particularly vulnerable to infections and resulting complications. The transfer of maternal antibodies across the placenta protects infants who are too young to be vaccinated. When breastfeeding, this continues through antibodies in breast milk. For the vaccinations recommended by the Standing Vaccination Committee (STIKO) during pregnancy (influenza, pertussis, coronavirus disease [COVID]-19), there is clear evidence from various observational and prospective studies that they protect mother and child either from infection or from a severe disease course. The following article gives an overview of the vaccination strategy for pregnancy and summarizes the scientific data on effectiveness of the vaccinations currently recommended during pregnancy.

2.
Die Gynäkologie ; : 1-6, 2022.
Article in German | EuropePMC | ID: covidwho-2012670

ABSTRACT

Impfungen sind eine der größten Errungenschaften zum Schutz der öffentlichen Gesundheit. Impfstoffe, die schwangeren Frauen verabreicht werden, schützen dabei nicht nur die Schwangere selbst, sondern auch das Neugeborene. Schwangere Frauen sind von Infektionen unverhältnismäßig stark beeinträchtigt. Die widersprüchlichen Anforderungen an das mütterliche Immunsystem während der Schwangerschaft, mit dem Ziel, die fetale Immuntoleranz aufrechtzuerhalten, erschweren eine schnelle und effektive Immunantwort gegen Krankheitserreger. Dieser dynamische Zustand der Immunadaptation prädisponiert Schwangere für schwerere Krankheitsverläufe. Durch eine Impfung kann einer Infektion oder einem schweren Krankheitsverlauf vorgebeugt werden. In der Folge sinkt auch das Risiko einer Frühgeburt und anderer schwerer Schwangerschaftskomplikationen, die lebenslange Folgen für Mutter und Kind haben können. Nach der Geburt muss das Neugeborene zunächst ein adaptives Gedächtnis für eine bis dahin unbekannte, antigenreiche Umgebung entwickeln;es ist für Infektionen und die daraus resultierenden Komplikationen besonders vulnerabel. Durch den Transfer maternaler Antikörper über die Plazenta werden Säuglinge geschützt, die zu jung sind, um geimpft zu werden. Beim Stillen setzt sich dies durch die Muttermilch fort. Für die von der Ständigen Impfkommission (STIKO) empfohlenen Impfungen in der Schwangerschaft (Influenza, Pertussis, COVID[„coronavirus disease“]-19), gibt es eindeutige Hinweise aus verschiedenen prospektiven und observationellen Studien, dass sie Mutter und Kind entweder vor einer Infektion oder einem schweren Krankheitsverlauf effektiv schützen. Im Beitrag geben wir einen Überblick über die Impfstrategie rund um die Schwangerschaft und fassen die wissenschaftlichen Daten zur Wirksamkeit der empfohlenen Impfungen zusammen.

4.
J Reprod Immunol ; 153: 103685, 2022 09.
Article in English | MEDLINE | ID: covidwho-1966885

ABSTRACT

Breast milk is a pivotal source to provide passive immunity in newborns over the first few months of life. Very little is known about the antibody transfer levels over the period of breastfeeding. We conducted a prospective study in which we evaluated concentrations of anti-SARS-CoV-2 Spike IgA and RBD IgG/M/A antibodies in maternal serum and breast milk over a duration of up to 6 months after delivery. We compared antibody levels in women with confirmed COVID-19 infection during pregnancy (n = 16) to women with prenatal SARS-CoV-2 vaccination (n = 5). Among the recovered women, n = 7 (44%) had been vaccinated during the lactation period as well. We observed intraindividual moderate positive correlations between antibody levels in maternal serum and breast milk (r = 0.73, p-value<0.0001), whereupon the median levels were generally higher in serum. Anti-RBD IgA/M/G transfer into breast milk was significantly higher in women recovered from COVID-19 and vaccinated during lactation (35.15 AU/ml; IQR 21.96-66.89 AU/ml) compared to the nonvaccinated recovered group (1.26 AU/ml; IQR 0.49-3.81 AU/ml), as well as in the vaccinated only group (4.52 AU/ml; IQR 3.19-6.23 AU/ml). Notably, the antibody level in breast milk post SARS-CoV-2 infection sharply increased following a single dose of vaccine. Breast milk antibodies in all groups showed neutralization capacities against an early pandemic SARS-CoV-2 isolate (HH-1) and moreover, also against the Omicron variant, although with lower antibody titer. Our findings highlight the importance of booster vaccinations especially after SARS-CoV-2 infection in pregnancy in order to optimize protection in mother and newborn.


Subject(s)
COVID-19 , Viral Vaccines , Antibodies, Viral , Breast Feeding , COVID-19/prevention & control , COVID-19 Vaccines , Cohort Studies , Female , Humans , Immunoglobulin A , Immunoglobulin G , Infant, Newborn , Lactation , Milk, Human , Prospective Studies , SARS-CoV-2 , Vaccination
5.
Front Immunol ; 12: 698578, 2021.
Article in English | MEDLINE | ID: covidwho-1278398

ABSTRACT

Pregnant women have been carefully observed during the COVID-19 pandemic, as the pregnancy-specific immune adaptation is known to increase the risk for infections. Recent evidence indicates that even though most pregnant have a mild or asymptomatic course, a severe course of COVID-19 and a higher risk of progression to diseases have also been described, along with a heightened risk for pregnancy complications. Yet, vertical transmission of the virus is rare and the possibility of placental SARS-CoV-2 infection as a prerequisite for vertical transmission requires further studies. We here assessed the severity of COVID-19 and onset of neonatal infections in an observational study of women infected with SARS-CoV-2 during pregnancy. Our placental analyses showed a paucity of SARS-CoV-2 viral expression ex vivo in term placentae under acute infection. No viral placental expression was detectable in convalescent pregnant women. Inoculation of placental explants generated from placentas of non-infected women at birth with SARS-CoV-2 in vitro revealed inefficient SARS-CoV-2 replication in different types of placental tissues, which provides a rationale for the low ex vivo viral expression. We further detected specific SARS-CoV-2 T cell responses in pregnant women within a few days upon infection, which was undetectable in cord blood. Our present findings confirm that vertical transmission of SARS-CoV-2 is rare, likely due to the inefficient virus replication in placental tissues. Despite the predominantly benign course of infection in most mothers and negligible risk of vertical transmission, continuous vigilance on the consequences of COVID-19 during pregnancy is required, since the maternal immune activation in response to the SARS-CoV2 infection may have long-term consequences for children's health.


Subject(s)
COVID-19/immunology , COVID-19/transmission , Infectious Disease Transmission, Vertical , Placenta/virology , Pregnancy Complications, Infectious/immunology , Adult , Female , Fetal Blood/immunology , Humans , Infant, Newborn , Middle Aged , Placenta/immunology , Pregnancy , SARS-CoV-2/immunology , Virus Replication/physiology
6.
Vouga, Manon, Favre, Guillaume, Martinez Perez, Oscar, Pomar, Leo, Forcen Acebal, Laura, Abascal, Alejandra, Vila Hernandez, Maria Rosa, Hcini, Najeh, Lambert, Véronique, Carles, Gabriel, Sichitiu, Joanna, Salomon, Laurent, Stiremann, Julien, Ville, Yves, Martinez de Tejada, Begoña, Goncé, Anna, Hawkins-Villareal, Ameth, Castillo, Karen, Gratacos Solsona, Eduard, Trigo, Lucas, Cleary, Brian, Geary, Michael, Bartels, Helena, Al-Kharouf, Feras, Malone, Fergal, Higgins, Mary, Keating, Niamh, Knowles, Susan, Poncelet, Christophe, Carvalho, Carolina, Ribeiro-do-Valle, Fernanda, Surita, Garanhani, Dantas-Silva, Amanda, Borrelli, Carolina, Gomes Luz, Adriana, Fuenzalida, Javiera, Carvajal, Jorge, Guerra Canales, Manuel, Hernandez, Olivia, Grechukhina, Olga, Ko, Albert I.; Reddy, Uma, Figueiredo, Rita, Moucho, Marina, Viana Pinto, Pedro, De Luca, Carmen, De Santis, Marco, Ayres de Campos, Diogo, Garabedian, Charles, Subtil, Damien, Bohrer, Betania, Da Rocha Oppermann, Maria Lucia, Celeste, Maria, Wender, Osorio, Schuler-Faccini, Lavinia, Vieira Sanseverino, Maria Teresa, Giugliani, Camila, Friedrich, Luciana, Horn Scherer, Mariana, Mottet, Nicolas, Ducarme, Guillaume, Pelerin, Helene, Moreau, Chloe, Breton, Bénédicte, Quibel, Thibaud, Rozenberg, Patrick, Mueller, Doris, Granado, Cristina, Hoesli, Irene, Monod, Cécile, Bassler, Dirk, Heldstab, Sandra, Ochsenbein Kölble, Nicole, Sentilhes, Loïc, Charvet, Melissa, Deprest, Jan, Richter, Jute, Van der Veeken, Lennart, Eggel-Hort, Béatrice, Plantefeve, Gaetan, Derouich, Mohamed, Nieto Calvache, Albaro José, Lopez-Giron, Maria Camila, Burgos-Luna, Juan Manuel, Escobar-Vidarte, Maria Fernanda, Hecher, Kurt, Tallarek, Ann-Christin, Hadar, Eran, Krajden Haratz, Karina, Malinger, Gustavo, Maymon, Ron, Yogev, Yariv, Schäffer, Leonhard, Toussaint, Arnaud, Rossier, Marie-Claude, Moreira de sa, Renato Augusto, Grawe, Claudia, Aebi-Popp, Karoline, Radan, Anda-Petronela, Raio, Luigi, Surbek, Daniel, Böckenhoff, Paul, Strizek, Brigitte, Kaufmann, Martin, Bloch, Andrea, Boulvain, Michel, Johann, Silke, Heldstab, Sandra Andrea, Todesco Bernasconi, Monya, Grant, Gaston, Feki, Anis, Muller Brochut, Anne-Claude, Giral, Marylene, Sedille, Lucie, Papadia, Andrea, Capoccia Brugger, Romina, Weber, Brigitte, Fischer, Tina, Kahlert, Christian, Nielsen Saines, Karin, Cambou, Mary, Kanellos, Panagiotis, Chen, Xiang, Yin, Mingzhu, Haessig, Annina, Baud, David, Panchaud, Alice.
SSRN; 2020.
Preprint in English | SSRN | ID: ppcovidwho-2803
7.
Vouga, Manon, Favre, Guillaume, Martinez Perez, Oscar, Pomar, Leo, Forcen Acebal, Laura, Abascal, Alejandra, Vila Hernandez, Maria Rosa, Hcini, Najeh, Lambert, Véronique, Carles, Gabriel, Sichitiu, Joanna, Salomon, Laurent, Stiremann, Julien, Ville, Yves, Martinez de Tejada, Begoña, Goncé, Anna, Hawkins-Villareal, Ameth, Castillo, Karen, Gratacos Solsona, Eduard, Trigo, Lucas, Cleary, Brian, Geary, Michael, Bartels, Helena, Al-Kharouf, Feras, Malone, Fergal, Higgins, Mary, Keating, Niamh, Knowles, Susan, Poncelet, Christophe, Carvalho, Carolina, Ribeiro-do-Valle, Fernanda, Surita, Garanhani, Dantas-Silva, Amanda, Borrelli, Carolina, Gomes Luz, Adriana, Fuenzalida, Javiera, Guerra Canales, Manuel, Hernandez, Olivia, Grechukhina, Olga, Ko, Albert, Reddy, Uma, Figueiredo, Rita, Moucho, Marina, Viana Pinto, Pedro, De Luca, Carmen, De Santis, Marco, Ayres de Campos, Diogo, Garabedian, Charles, Subtil, Damien, Bohrer, Betania, Da Rocha Oppermann, Maria Lucia, Celeste, Maria, Wender, Osorio, Schuler-Faccini, Lavinia, Vieira Sanseverino, Maria Teresa, Giugliani, Camila, Friedrich, Luciana, Horn Scherer, Mariana, Mottet, Nicolas, Ducarme, Guillaume, Pelerin, Helene, Moreau, Chloe, Breton, Bénédicte, Quibel, Thibaud, Rozenberg, Patrick, Mueller, Doris, Granado, Cristina, Hoesli, Irene, Monod, Cécile, Bassler, Dirk, Heldstab, Sandra, Ochsenbein Kölble, Nicole, Sentilhes, Loïc, Charvet, Melissa, Deprest, Jan, Richter, Jute, Van der Veeken, Lennart, Eggel-Hort, Béatrice, Plantefeve, Gaetan, Derouich, Mohamed, Nieto Calvache, Albaro José, Lopez-Giron, Maria Camila, Burgos-Luna, Juan Manuel, Escobar-Vidarte, Maria Fernanda, Hecher, Kurt, Tallarek, Ann-Christin, Hadar, Eran, Krajden Haratz, Karina, Malinger, Gustavo, Maymon, Ron, Yogev, Yariv, Schäffer, Leonhard, Toussaint, Arnaud, Rossier, Marie-Claude, Moreira de sa, Renato Augusto, Grawe, Claudia, Aebi-Popp, Karoline, Radan, Anda-Petronela, Raio, Luigi, Surbek, Daniel, Böckenhoff, Paul, Strizek, Brigitte, Kaufmann, Martin, Bloch, Andrea, Boulvain, Michel, Johann, Silke, Todesco Bernasconi, Monya, Grant, Gaston, Feki, Anis, Muller Brochut, Anne-Claude, Giral, Marylene, Sedille, Lucie, Papadia, Andrea, Capoccia Brugger, Romina, Weber, Brigitte, Fischer, Tina, Kahlert, Christian, Nielsen Saines, Karin, Cambou, Mary, Kanellos, Panagiotis, Chen, Xiang, Yin, Mingzhu, Haessig, Annina, Baud, David, Panchaud, Alice.
SSRN; 2020.
Preprint in English | SSRN | ID: ppcovidwho-2498
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