Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, the Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, the Department of Obstetrics and Gynecology, NYU Langone Health & NYU Grossman School of Medicine, New York, the Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, and the Department of Obstetrics and Gynecology, NYC Health and Hospitals-Elmhurst, Elmhurst, New York.
Obstet Gynecol. 2020 Aug;136(2):273-282. doi: 10.1097/AOG.0000000000004025.
To describe the characteristics and birth outcomes of women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as community spread in New York City was detected in March 2020.
We performed a prospective cohort study of pregnant women with laboratory-confirmed SARS-CoV-2 infection who gave birth from March 13 to April 12, 2020, identified at five New York City medical centers. Demographic and clinical data from delivery hospitalization records were collected, and follow-up was completed on April 20, 2020.
Among this cohort (241 women), using evolving criteria for testing, 61.4% of women were asymptomatic for coronavirus disease 2019 (COVID-19) at the time of admission. Throughout the delivery hospitalization, 26.5% of women met World Health Organization criteria for mild COVID-19, 26.1% for severe, and 5% for critical. Cesarean birth was the mode of delivery for 52.4% of women with severe and 91.7% with critical COVID-19. The singleton preterm birth rate was 14.6%. Admission to the intensive care unit was reported for 17 women (7.1%), and nine (3.7%) were intubated during their delivery hospitalization. There were no maternal deaths. Body mass index (BMI) 30 or higher was associated with COVID-19 severity (P=.001). Nearly all newborns tested negative for SARS-CoV-2 infection immediately after birth (97.5%).
During the first month of the SARS-CoV-2 outbreak in New York City and with evolving testing criteria, most women with laboratory-confirmed infection admitted for delivery did not have symptoms of COVID-19. Almost one third of women who were asymptomatic on admission became symptomatic during their delivery hospitalization. Obesity was associated with COVID-19 severity. Disease severity was associated with higher rates of cesarean and preterm birth.
描述 2020 年 3 月纽约市发现社区传播的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的女性的特征和分娩结局。
我们对 2020 年 3 月 13 日至 4 月 12 日在纽约市 5 家医疗中心分娩的实验室确诊 SARS-CoV-2 感染的孕妇进行了一项前瞻性队列研究。收集分娩住院记录中的人口统计学和临床数据，并于 2020 年 4 月 20 日完成随访。
在该队列中（241 名女性），使用不断变化的检测标准，61.4%的女性在入院时无症状。在整个分娩住院期间，26.5%的女性符合世界卫生组织轻度 COVID-19 标准，26.1%为重度，5%为危重。52.4%患有严重 COVID-19 和 91.7%患有危急 COVID-19 的女性行剖宫产分娩。单胎早产率为 14.6%。报告有 17 名女性（7.1%）入住重症监护病房，9 名女性（3.7%）在分娩住院期间插管。无孕产妇死亡。BMI（体重指数）≥30 与 COVID-19 严重程度相关（P=0.001）。几乎所有新生儿出生后立即 SARS-CoV-2 检测均为阴性（97.5%）。
在 SARS-CoV-2 疫情在纽约市爆发的第一个月，随着检测标准的不断变化，大多数因实验室确诊感染而住院分娩的女性没有 COVID-19 症状。几乎三分之一入院时无症状的女性在分娩住院期间出现症状。肥胖与 COVID-19 严重程度相关。疾病严重程度与更高的剖宫产和早产率相关。
