Abstract：
OBJECTIVE: COVID-19 has been associated with preterm birth (PTB) and placental-mediated complications, including fetal growth restriction and preeclampsia (PE). This study aimed to estimate the impact of COVID-19 and vaccination on adverse pregnancy outcomes and markers of placental function.
METHODS: We performed a study on a prospective cohort of women recruited in the first trimester of pregnancy during the early COVID-19 pandemic period (December 2020 to December 2021). At each trimester of pregnancy, the assessment included a questionnaire on COVID-19 and vaccination status; serological tests for COVID-19 (for asymptomatic infection); measurement of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) in maternal blood; measurement of mean uterine artery pulsatility index (UtA-PI); and pregnancy outcomes (PTB, PE, birth weight below the fifth and the tenth percentile).
RESULTS: Among 788 patients with complete data, we observed 101 (13%) cases of symptomatic infection and 74 (9%) cases of asymptomatic infection with SARS-CoV-2. Most cases (73%) of infection were among women with previous vaccination or COVID-19 infection before pregnancy. COVID-19 infection was not associated with adverse pregnancy outcomes, abnormal fetal growth, sFlt-1/PlGF ratio, or mean UtA-PI. Vaccination during pregnancy did not influence these outcomes either. We observed no case of severe COVID-19 infection requiring respiratory support.
CONCLUSIONS: Mild symptomatic or asymptomatic COVID-19 during pregnancy did not influence the risk of adverse pregnancy outcomes and the markers of placental function in predominantly vaccinated women. Fetal growth monitoring is unlikely to be mandatory in women with mild symptoms of COVID-19.
METHODS: We performed a study on a prospective cohort of women recruited in the first trimester of pregnancy during the early COVID-19 pandemic period (December 2020 to December 2021). At each trimester of pregnancy, the assessment included a questionnaire on COVID-19 and vaccination status; serological tests for COVID-19 (for asymptomatic infection); measurement of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) in maternal blood; measurement of mean uterine artery pulsatility index (UtA-PI); and pregnancy outcomes (PTB, PE, birth weight below the fifth and the tenth percentile).
RESULTS: Among 788 patients with complete data, we observed 101 (13%) cases of symptomatic infection and 74 (9%) cases of asymptomatic infection with SARS-CoV-2. Most cases (73%) of infection were among women with previous vaccination or COVID-19 infection before pregnancy. COVID-19 infection was not associated with adverse pregnancy outcomes, abnormal fetal growth, sFlt-1/PlGF ratio, or mean UtA-PI. Vaccination during pregnancy did not influence these outcomes either. We observed no case of severe COVID-19 infection requiring respiratory support.
CONCLUSIONS: Mild symptomatic or asymptomatic COVID-19 during pregnancy did not influence the risk of adverse pregnancy outcomes and the markers of placental function in predominantly vaccinated women. Fetal growth monitoring is unlikely to be mandatory in women with mild symptoms of COVID-19.
摘要：
背景：COVID-19与早产和胎盘介导的并发症包括胎儿生长受限有关，目的：评估COVID-19和疫苗接种对不良妊娠结局和胎盘功能标志物的影响。
方法：我们对在COVID-19流行早期（2020年12月至2021年12月）的妊娠前三个月招募的妇女进行了前瞻性队列研究。在怀孕的每三个月，评估包括一份关于COVID-19和疫苗接种状况的问卷；COVID-19的血清学检查（无症状感染）；测量母体血液中的胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶1（sFlt-1）；测量平均子宫动脉搏动指数（UtA-PI）；和妊娠结局（早产，先兆子痫,出生体重低于第5和第10百分位）。
结果：在788名数据完整的患者中，我们观察到101例（13％）有症状感染和74例（9％）无症状感染SARS-CoV-2。大多数感染病例（73％）是在怀孕前接种过疫苗或感染过COVID-19的妇女。COVID-19感染与不良妊娠结局无关，胎儿生长异常,sFlt-1/PlGF比值,或表示UtA-PI。怀孕期间的疫苗接种也不影响这些结果。我们没有观察到需要呼吸支持的严重COVID-19感染病例。
结论：妊娠期间轻度有症状或无症状的COVID-19不会影响主要接种疫苗的妇女的不良妊娠结局风险和胎盘功能标志物。对于有轻度COVID-19症状的女性，胎儿生长监测不太可能是强制性的。
方法：我们对在COVID-19流行早期（2020年12月至2021年12月）的妊娠前三个月招募的妇女进行了前瞻性队列研究。在怀孕的每三个月，评估包括一份关于COVID-19和疫苗接种状况的问卷；COVID-19的血清学检查（无症状感染）；测量母体血液中的胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶1（sFlt-1）；测量平均子宫动脉搏动指数（UtA-PI）；和妊娠结局（早产，先兆子痫,出生体重低于第5和第10百分位）。
结果：在788名数据完整的患者中，我们观察到101例（13％）有症状感染和74例（9％）无症状感染SARS-CoV-2。大多数感染病例（73％）是在怀孕前接种过疫苗或感染过COVID-19的妇女。COVID-19感染与不良妊娠结局无关，胎儿生长异常,sFlt-1/PlGF比值,或表示UtA-PI。怀孕期间的疫苗接种也不影响这些结果。我们没有观察到需要呼吸支持的严重COVID-19感染病例。
结论：妊娠期间轻度有症状或无症状的COVID-19不会影响主要接种疫苗的妇女的不良妊娠结局风险和胎盘功能标志物。对于有轻度COVID-19症状的女性，胎儿生长监测不太可能是强制性的。
