Neutralizing antibodies in milk and blood of lactating women vaccinated for SARS-CoV-2: a systematic review / Anticorpos neutralizantes no leite e no sangue de lactantes vacinadas para SARS-CoV-2: uma revisão sistemática

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas.

Neutralizing antibodies in milk and blood of lactating women vaccinated for SARS-CoV-2: a systematic review.

OBJECTIVE: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. DATA SOURCE: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. DATA SYNTHESIS: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. CONCLUSIONS: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

Quality, reliability, and content of YouTube videos in Portuguese language about dental trauma / Qualidade, confiabilidade e conteúdo de vídeos do Youtube na língua Portuguesa sobre traumatismo dentário

Objective: To evaluate the quality, reliability and content of YouTube videos in Portuguese about dental trauma. Method: An infodemiological study was developed in which the first 60 videos found on YouTube with the terms "dental traumatism", "dental trauma" and "broken tooth" were analyzed. Repeated videos, longer than one hour, in a language other than Portuguese, not intended for the lay public, resolution of questions, songs, interviews, shorts, and other subjects were excluded. The content of the videos was rated using a 23-point scale that classified them into low, moderate, and high content. Reliability was assessed using the modified DISCERN scale and the overall quality was assessed using the Global Quality Score (GQS) scale. The numbers of likes, dislikes, comments and engagement were also accounted. Data were analyzed by Mann-Whitney and Spearman's correlation test (α= 5%). Result: A total of 55 videos were included in the study. Most were posted by healthcare professionals (92.7%) and just over half (63.7%) were of good overall quality. There were moderate, positive, and statistically significant correlations between DISCERN and GQS scores (r=0.454), duration (r=0.575), and trauma content (r=0.510). Overall quality correlated moderately, positively, and significantly with content scores (r=0.604) and video length (r=0.467). Conclusion: A significant proportion of Portuguese videos on YouTube about dental trauma had low content, quality and reliability information.

Objetivo: Avaliar a qualidade, a confiabilidade e o conteúdo de vídeos do YouTube na língua portuguesa sobre traumatismo dentário. Método: Um estudo infodemiológico foi desenvolvido a partir de uma busca no YouTube e os 60 primeiros vídeos encontrados com cada um dos termos "traumatismo dentário", "trauma dental" e "dente quebrado" foram analisados. Vídeos repetidos, com mais de uma hora de duração, em outro idioma, não destinados ao público leigo, resolução de questões, músicas, entrevistas, shorts, e vídeos sobre outras temáticas foram excluídos. O conteúdo dos vídeos foi avaliado usando uma escala de 23 pontos que os classificou em baixo, moderado e alto conteúdo. A confiabilidade foi avaliada utilizando a escala DISCERN modificada e a qualidade geral foi avaliada com a escala Global Quality Score (GQS). Também foram contabilizados os números de curtidas, dislikes, comentários e engajamento. Os dados foram analisados pelos testes de Mann-Whitney e correlação de Spearman (α = 5%). Resultado: 55 vídeos foram incluídos no estudo. A maioria foi postada por profissionais de saúde (92,7%) e pouco mais da metade (63,7%) foi de qualidade geral boa. Houve uma correlação moderada, positiva e estatisticamente significativa entre os escores do DISCERN e do GQS (r = 0,454), duração (r = 0,575) e conteúdo de trauma (r = 0,510). A qualidade geral se correlacionou de forma moderada, positiva e significativa com os escores de conteúdo (r = 0,604) e com a duração do vídeo (r = 0,467). Conclusão:Uma proporção de vídeos em Português presentes no YouTube sobre traumatismo dentário possui informações de baixo conteúdo, qualidade e confiabilidade.

Prevalence of postpartum depression symptoms in high-income, and low- and middle-income countries in the Covid-19 pandemic: a systematic review with meta-analysis.

OBJECTIVE: To perform a meta-analysis and comparison between high-income, and low- and middle-income countries postpartum depression symptoms prevalences. METHODS: PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO and CINAHL databases were searched until October 2022 for studies that collected data from pandemic. The metaprop command was used in the Stata statistical software v.12.0 to run a random-effects meta-analysis. RESULTS: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of postpartum depression symptoms was 31% (95% CI: 21.85-40.99). The pooled prevalence of postpartum depression symptoms among women from high-income countries [30.5% (95% CI: 16.95-46.02)] did not differ significantly from that among women from low- and middle-income countries [31.5% (95% CI: 19.26-45.15)]. However, studies that analyzed women up to one month after childbirth had a lower prevalence of postpartum depression symptoms [17.5% (95% CI: 9.85-26.62)] compared to those that observed them up to one year after childbirth [38.3% (95% CI: 33.96-42.83)]. CONCLUSIONS: The prevalence of postpartum depression symptoms was high regardless of the country's human development index and it must be regularly tracked around the world to assess, discuss, and recommend more assertive steps that may be implemented based on the particular characteristics of each country.

Prevalence of postpartum depression symptoms in high-income and low- and middle-income countries in the COVID-19 pandemic: a systematic review with meta-analysis

Objective: To compare the prevalence of postpartum depression (PPD) symptoms between high-income countries (HIC) and low- and middle-income countries (LMIC) during the COVID-19 pandemic. Methods: The PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO, and CINAHL databases were searched until October 2022 for studies that collected data during the pandemic. The metaprop command was used in the Stata statistical software version 12.0 to run a random-effects meta-analysis. Results: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of PPD symptoms was 31% (95%CI 21.85-40.99). The pooled prevalence of PPD symptoms among women from HIC (30.5% [95%CI 16.95-46.02]) did not differ significantly from that of women from LMIC (31.5% [95%CI 19.26-45.15]). However, studies that analyzed women up to 1 month after childbirth reported a lower prevalence of PPD symptoms (17.5% [95%CI 9.85-26.62]) compared to those that observed them up to 1 year after childbirth (38.3% [95%CI 33.96-42.83]). Conclusions: The prevalence of PPD symptoms was high across countries, regardless of human development index. This condition must be regularly tracked worldwide to assess, discuss, and recommend more assertive steps that may be implemented to address it based on the particular characteristics of each country. Registration number: PROSPERO CRD42022346861.

Anticorpos neutralizantes contra o vírus SARS-coV-2 no sangue e leite humano de lactantes previamente vacinadas / Neutralizing antibodies against the SARS-coV-2 virus in the blood and human milk of previously vaccinated infants

Introdução: Alguns estudos verificaram que a vacinação contra o coronavírus SARS COV-2 induz resposta efetiva de titulação de anticorpos neutralizantes no sangue e leite materno. No entanto, a maioria dos artigos publicados considerou a transferência de imunidade mãe-feto em mulheres recuperadas da COVID-19 e não vacinadas e/ou analisaram leite e/ou sangue isoladamente. Objetivo: Comparar o quantitativo de anticorpos neutralizantes contra o SARS-CoV-2 no leite e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Métodos: Revisão sistemática nas bases de dados Biblioteca Virtual em Saúde, Pubmed, Embase, Web of Science e Scopus de acordo com as diretrizes do PRISMA e registrada no PROSPERO sob o n° CRD42021287554. Foram elegíveis estudos de coorte, caso-controle e transversal que avaliaram a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e que tiveram como grupo controle lactantes não vacinadas. Por sua vez, foram excluídos relatos de casos, revisão sistemática com ou sem meta-análise, artigos que analisaram os anticorpos em mulheres infectadas ou não lactantes, e ainda aqueles que não trouxeram nos seus resultados os dados de comparação entre os grupos que receberam ou não a vacina. Foi avaliado o risco de viés de todos os artigos incluídos através da ferramenta de avaliação Newcastle-Ottawa Scale. Resultados: As buscas nas bases de dados identificaram 233 registros. Após a remoção de 128 que estavam duplicados, foram lidos os títulos e resumos de 105 e excluídos 94 destes. Com a leitura na íntegra de 11 artigos, 4 estudos de coorte foram considerados elegíveis e, incluídos nesta revisão sistemática. Os resultados destes estudos apontaram que, após a vacinação com os imunizantes Pfizer-BioNTech e Moderna, as lactantes apresentaram níveis elevados de anticorpos neutralizantes IgG e IgA anti-SARS-CoV-2 tanto no sangue quanto no leite materno, sendo o nível sanguíneo consideravelmente maior. Conclusão: Como ainda não existem vacinas disponíveis para uso em menores de seis meses e as lactantes vacinadas contra o vírus SARS-CoV-2 apresentam maior expressão de anticorpos em relação àquelas não vacinadas, é provável que, além da proteção materna contra COVID-19, a imunização também forneça imunidade neonatal através da amamentação.

Introduction: Some studies have found that vaccination against the SARS-COV-2 coronavirus induces an effective titration response of neutralizing antibodies in blood and breast milk. However, most published articles considered the transfer of mother fetus immunity in women recovered from COVID-19 and not vaccinated and/or analyzed milk and/or blood alone. Objective: To compare the amount of neutralizing antibodies in the milk and blood of vaccinated infants for SARS-CoV-2. Methods: Systematic review in the Virtual Health Library, Pubmed, Embase, Web of Science and Scopus databases in accordance with PRISMA guidelines and registered in PROSPERO under number CRD42021287554. Cohort, case-control and cross-sectional studies that evaluated the presence of neutralizing antibodies against SARS-CoV-2 in the milk and blood of vaccinated infants and that had unvaccinated infants as a control group were eligible. In turn, case reports, systematic review with or without meta-analysis, articles that analyzed antibodies in infected or non-lactating women, and even those that did not bring in their results data for comparison between the groups that received or not the vaccine. The risk of bias of all included articles was assessed using the Newcastle Ottawa Scale assessment tool. Results: Database searches identified 233 records. After removing 128 that were duplicates, the titles and abstracts of 105 were read and 94 were excluded. With the full reading of 11 articles, 4 cohort studies were considered eligible and included in this systematic review. The results of these studies showed that, after vaccination with the immunizers Pfizer-BioNTech and Moderna, the nursing mothers had high levels of anti-SARS-CoV-2 IgG and IgA neutralizing antibodies both in the blood and in breast milk, with the blood level considerably bigger. Conclusion: As there are still no vaccines available for use in infants under six months of age and lactating women vaccinated against the SARS-CoV-2 virus have a higher expression of antibodies compared to those not vaccinated, it is likely that, in addition to maternal protection against COVID-19, immunization also provides neonatal immunity through breastfeeding.