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新型冠状病毒肺炎疫情期间妊娠初始数据综述:对辅助生殖治疗的启示

A review of initial data on pregnancy during the COVID-19 outbreak: implications for assisted reproductive treatments.

作者信息

Monteleone Pedro Aa, Nakano Mayra, Lazar Victor, Gomes Alecsandra P, de Hamilton, Bonetti Tatiana Cs

机构信息

Centro de Reprodução Humana Monteleone.

Disciplina de Ginecologia - Departamento de Obstetrícia e Ginecologia. Faculdade de Medicina da Universidade de São Paulo (FMUSP).

出版信息

JBRA Assist Reprod. 2020 May 1;24(2):219-225. doi: 10.5935/1518-0557.20200030.

Abstract

The current outbreak of the novel 2019 coronavirus disease (COVID-19) started in China in December 2019 and has since spread to several other countries. On March 25, 2020, a total of 375,498 cases had been confirmed globally with 2,201 cases in Brazil, showing the urgency of reacting to this international public health emergency. While in most cases, mild symptoms are observed, in some cases the infection leads to serious pulmonary disease. As a result, the possible consequences of the COVID-19 outbreak for pregnant women and its potential effects on the management of assisted reproductive treatments, demand attention. In this review, we summarize the latest research progress related to COVID-19 epidemiology and the reported data of pregnant women, and discuss the current evidence of COVID-19 infections during pregnancy and its potential consequences for assisted reproductive treatments. Reported data suggest that symptoms in pregnant women are similar to those in other people, and that there is no evidence for higher maternal or fetal risks. However, considering the initial data and lack of comprehensive knowledge on the pathogenesis of SARS-CoV-2 during pregnancy, human reproduction societies have recommended postponing the embryo transfers and do not initiate new treatment cycles. New evidence must be considered carefully in order to adjust these recommendations accordingly at any time and to guide assisted reproductive treatments.

摘要

当前新型冠状病毒肺炎(COVID-19)疫情于2019年12月在中国爆发,此后已蔓延至其他多个国家。2020年3月25日,全球共确诊375498例病例,巴西有2201例,这显示了应对这一国际公共卫生紧急情况的紧迫性。虽然在大多数情况下观察到的是轻症,但在某些情况下感染会导致严重的肺部疾病。因此,COVID-19疫情对孕妇可能产生的后果及其对辅助生殖治疗管理的潜在影响值得关注。在本综述中,我们总结了与COVID-19流行病学相关的最新研究进展以及孕妇的报告数据,并讨论了孕期COVID-19感染的现有证据及其对辅助生殖治疗的潜在后果。报告数据表明,孕妇的症状与其他人相似,且没有证据表明孕产妇或胎儿风险更高。然而,考虑到初始数据以及对孕期严重急性呼吸综合征冠状病毒2(SARS-CoV-2)发病机制缺乏全面了解,人类生殖学会建议推迟胚胎移植,并且不启动新的治疗周期。必须仔细考虑新的证据,以便随时相应调整这些建议并指导辅助生殖治疗。

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