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孕妇 2019 冠状病毒病(COVID-19)肺炎的母婴结局:病例对照研究。

Maternal and Neonatal Outcomes of Pregnant Women With Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case-Control Study.

机构信息

Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, Hubei, China.

School of Nursing, Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.

出版信息

Clin Infect Dis. 2020 Nov 19;71(16):2035-2041. doi: 10.1093/cid/ciaa352.

Abstract

BACKGROUND

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.

METHODS

We conducted a case-control study to compare clinical characteristics and maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.

RESULTS

During the period 24 January-29 February 2020, there were 16 pregnant women with confirmed COVID-19 pneumonia and 18 suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest were cesarean delivery. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest computed tomographic images of COVID-19 pneumonia. Compared to the controls, patients with COVID-19 pneumonia had lower counts of white blood cells (WBCs), neutrophils, C-reactive protein (CRP), and alanine aminotransferase on admission. Increased levels of WBCs, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. Three (18.8%) of the mothers with confirmed COVID-19 pneumonia and 3 (16.7%) with suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than in the control group. None experienced respiratory failure during their hospital stay. COVID-19 infection was not found in the newborns, and none developed severe neonatal complications.

CONCLUSIONS

Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal or cesarean delivery. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.

摘要

背景

2019 年冠状病毒病(COVID-19)的持续大流行引起了人们对其对妊娠潜在不良影响的严重关注。关于 COVID-19 肺炎孕妇的母婴结局数据有限。

方法

我们进行了一项病例对照研究,比较了 COVID-19 肺炎孕妇和疑似孕妇的临床特征以及母婴结局。

结果

2020 年 1 月 24 日至 2 月 29 日期间,有 16 名确诊为 COVID-19 肺炎的孕妇和 18 名疑似妊娠晚期住院的孕妇。其中 2 例经阴道分娩,其余均行剖宫产。入院时少数患者有呼吸道症状(发热和咳嗽),但大多数均有典型的 COVID-19 肺炎胸部 CT 图像。与对照组相比,COVID-19 肺炎患者入院时白细胞(WBC)、中性粒细胞、C 反应蛋白(CRP)和丙氨酸氨基转移酶计数较低。肺炎患者产后血液检查发现白细胞(WBC)、中性粒细胞、嗜酸性粒细胞和 CRP 水平升高。3 名(18.8%)确诊 COVID-19 肺炎的母亲和 3 名(16.7%)疑似 COVID-19 肺炎的母亲因母亲并发症而早产,明显高于对照组。住院期间无呼吸衰竭发生。未在新生儿中发现 COVID-19 感染,也未发生严重新生儿并发症。

结论

COVID-19 肺炎孕妇行阴道分娩或剖宫产分娩时未观察到严重的母婴并发症。COVID-19 肺炎孕妇有轻度呼吸道症状,入院时需要进行有效的筛查。

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