The mortality burden associated with congenital defects (CD) is relevant globally and regionally. In 2016, the global prevalence of CD reached 82,890,000 cases. One out of five deaths within the first 28 days of life is due to CD. In addition to neonatal mortality due to CD, it contributes to fetal mortality.
Congenital defects (CDs) are the second leading cause of neonatal mortality and a very important cause of disease and disability.
In Latin America and the Caribbean, there are more than 15 million births every year. According to estimates published in 2018, approximately 15 out of every 1,000 will be at risk of dying before their first birthday and 10 in 1,000 before their first month of life.
One in 5 of the deaths occurring within the first 28 days of life is due to some CD.
According to the evidence available, vaccination against Covid 19 disease during pregnancy is safe for both mother and baby.
It is important to discuss this with the health care professional that cares for that pregnancy to promote an informed decision about immunization.
Unvaccinated pregnant women are at increased risk of becoming seriously ill, needing intensive care, and even dying. When they get Covid, birth may be triggered prematurely.
It is very important to discuss vaccinations with the professional who is monitoring pregnancy.
Here are the key issues concerning the vaccination of pregnant women, to be considered from the first antenatal visits:
Education. Conveying quality information can change one of the main barriers against vaccination, i.e., lack of knowledge about susceptibility to vaccine-preventable diseases, the morbidity caused by those diseases, and the risks and benefits of vaccines.
There is evidence about aspects that influence the population's acceptance of vaccines. These should be strategically considered by members of the health team and by those who manage resources for vaccination campaigns.
These aspects include:
Trust: In the efficacy and safety of vaccines and in the delivery system.
Indifference: Some people have a low perception of the risk of vaccine-preventable diseases, leading them to believe immunization is unnecessary. Indifference may be determined by underestimation of their benefit (efficacy or safety) or by knowledge gaps.
Sometimes, several vaccines must be administered simultaneously during pregnancy; such is the case of Tdap (tetanus and diphtheria toxoids with acellular pertussis vaccine) and influenza vaccine, for instance.
In studies that enrolled non-pregnant individuals to assess the safety of concurrent administration of Tdap and influenza vaccines, compared to their separate use, there was no evidence of increased risk of adverse events.
Several vaccines can be safely administered during pregnancy. In 2014, the WHO Global Advisory Committee on Vaccine Safety conducted a comprehensive assessment of the existing scientific data on the safety of vaccines during pregnancy, concluding that:
- Pregnancy should not prevent pregnant women from receiving a vaccine.
- Although live or attenuated microbial vaccines, such as the MMR vaccine, might pose a theoretical risk to the fetus, no major vaccination-associated adverse outcomes have been reported.
Attention should be focused on the 5 key moments advocated by the World Health Organization (WHO) and other situations associated with care of newborns*.
1. Before contact with the patient.
2. After contact with the patient.
3. Before invasive procedures.
4. After contact with secretions and body fluids.
5. Whenever preparing materials or equipment that are or have been in contact with patients and after contact with areas close to the patient.
* Whenever entering or leaving the hospital unit or isolation area.
Hand hygiene with alcohol or alcohol at 70% concentration with 2% glycerin can replace handwashing with water and soap when there is no visible dirt, especially in procedures at low risk for infection or in emergency situations.
In this procedure it is important to ensure the solution is rubbed on all surfaces of the hands, the fingers, and the spaces between the fingers, leaving the hands to dry spontaneously.
Surgical hand antisepsis
I Rub the hands with water and antiseptic detergent solution, including all surfaces, spaces
between the fingers, and nails; also wash the forearms.
II Rinse with running water.
III Wipe with sterile compress.
Note: this procedure should take 3 to 5 minutes for the first surgery and 2 to 3 minutes for subsequent surgeries.