PDF(Pubmed)
Abstract：
BACKGROUND: There is debate about the causes of the recent birth rate decline in high-income countries worldwide. During the pandemic, concern about the effects on reproductive health has caused vaccine hesitancy. We investigated the association of SARS-CoV-2 vaccination and infection with involuntary childlessness.
METHODS: Females in fertility age within a prospective multicenter cohort of healthcare workers (HCW) were followed since August 2020. Data on baseline health, SARS-CoV-2-infection, and vaccination were obtained and regularly updated, in which serum samples were collected repetitively and screened for anti-nucleocapsid and anti-spike antibodies. In October 2023, participants indicated the presence of involuntary childlessness with onset during the pandemic, whereas those indicating an onset before the pandemic were excluded. The association of involuntary childlessness and SARS-CoV-2-vaccination and infection was investigated using univariable and multivariable analysis. Sensitivity analysis was performed to compare those reporting involuntary childlessness with those birthing a child since 2020.
RESULTS: Of 798 participants, 26 (3.2%) reported involuntary childlessness starting since the pandemic. Of the involuntary childless women, 73.1% (19/26) were vaccinated compared to 86.0% (664/772) without involuntary childlessness (p = 0.73). SARS-CoV-2 infection was reported by 76.9% (20/26) compared to 72.4% (559/772) of controls (p = 0.64). Neither SARS-CoV-2 vaccination (aOR 0.91 per dose, 95%CI 0.67-1.26) nor infection (aOR per infection 1.05, 95%CI 0.62-1.71) was associated with involuntary childlessness. Sensitivity analysis confirmed these results.
CONCLUSIONS: Among female HCW of fertility age, 3.2% indicated involuntary childlessness, which is comparable to pre-pandemic data. No association between involuntary childlessness and SARS-CoV-2 vaccination or infection was found.
METHODS: Females in fertility age within a prospective multicenter cohort of healthcare workers (HCW) were followed since August 2020. Data on baseline health, SARS-CoV-2-infection, and vaccination were obtained and regularly updated, in which serum samples were collected repetitively and screened for anti-nucleocapsid and anti-spike antibodies. In October 2023, participants indicated the presence of involuntary childlessness with onset during the pandemic, whereas those indicating an onset before the pandemic were excluded. The association of involuntary childlessness and SARS-CoV-2-vaccination and infection was investigated using univariable and multivariable analysis. Sensitivity analysis was performed to compare those reporting involuntary childlessness with those birthing a child since 2020.
RESULTS: Of 798 participants, 26 (3.2%) reported involuntary childlessness starting since the pandemic. Of the involuntary childless women, 73.1% (19/26) were vaccinated compared to 86.0% (664/772) without involuntary childlessness (p = 0.73). SARS-CoV-2 infection was reported by 76.9% (20/26) compared to 72.4% (559/772) of controls (p = 0.64). Neither SARS-CoV-2 vaccination (aOR 0.91 per dose, 95%CI 0.67-1.26) nor infection (aOR per infection 1.05, 95%CI 0.62-1.71) was associated with involuntary childlessness. Sensitivity analysis confirmed these results.
CONCLUSIONS: Among female HCW of fertility age, 3.2% indicated involuntary childlessness, which is comparable to pre-pandemic data. No association between involuntary childlessness and SARS-CoV-2 vaccination or infection was found.
摘要：
背景：关于全球高收入国家近期出生率下降的原因存在争议。大流行期间,对生殖健康影响的担忧引起了疫苗的犹豫。我们调查了SARS-CoV-2疫苗接种和感染与非自愿无子女的关系。
方法：自2020年8月以来，在前瞻性多中心医疗工作者队列（HCW）中对处于生育年龄的女性进行了随访。基线健康数据，SARS-CoV-2感染,接种疫苗并定期更新，其中重复收集血清样品，并筛选抗核衣壳和抗刺突抗体。2023年10月，参与者表示在大流行期间出现了非自愿无子女，而那些表明在大流行前发病的被排除.使用单变量和多变量分析研究了非自愿无子女与SARS-CoV-2疫苗接种和感染的关系。进行了敏感性分析，以比较自2020年以来报告非自愿无子女的人与分娩的人。
结果：在798名参与者中，26人(3.2%)报告自大流行以来开始非自愿无子女。在非自愿无子女的妇女中，73.1％（19/26）接种了疫苗，而86.0％（664/772）没有非自愿无子女（p=0.73）。SARS-CoV-2感染报告为76.9％（20/26），而对照组为72.4％（559/772）（p=0.64）。既没有SARS-CoV-2疫苗接种(每剂量aOR0.91，95CI0.67-1.26）无感染（每次感染的OR为1.05，95CI0.62-1.71）与非自愿无子女有关。敏感性分析证实了这些结果。
结论：在生育年龄的女性HCW中，3.2%表示非自愿无子女，这与大流行前的数据相当。未发现非自愿无子女与SARS-CoV-2疫苗接种或感染之间存在关联。
方法：自2020年8月以来，在前瞻性多中心医疗工作者队列（HCW）中对处于生育年龄的女性进行了随访。基线健康数据，SARS-CoV-2感染,接种疫苗并定期更新，其中重复收集血清样品，并筛选抗核衣壳和抗刺突抗体。2023年10月，参与者表示在大流行期间出现了非自愿无子女，而那些表明在大流行前发病的被排除.使用单变量和多变量分析研究了非自愿无子女与SARS-CoV-2疫苗接种和感染的关系。进行了敏感性分析，以比较自2020年以来报告非自愿无子女的人与分娩的人。
结果：在798名参与者中，26人(3.2%)报告自大流行以来开始非自愿无子女。在非自愿无子女的妇女中，73.1％（19/26）接种了疫苗，而86.0％（664/772）没有非自愿无子女（p=0.73）。SARS-CoV-2感染报告为76.9％（20/26），而对照组为72.4％（559/772）（p=0.64）。既没有SARS-CoV-2疫苗接种(每剂量aOR0.91，95CI0.67-1.26）无感染（每次感染的OR为1.05，95CI0.62-1.71）与非自愿无子女有关。敏感性分析证实了这些结果。
结论：在生育年龄的女性HCW中，3.2%表示非自愿无子女，这与大流行前的数据相当。未发现非自愿无子女与SARS-CoV-2疫苗接种或感染之间存在关联。
