University Hospitals of Birmingham, Institute of Genomics and Cancer Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Obstetrics and Gynaecology Registrar, University Hospitals of Birmingham, Birmingham B9 5SS, UK; University Hospitals of Birmingham, Birmingham B9 5SS, UK.
Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:559-562. doi: 10.1016/j.ejogrb.2020.07.008. Epub 2020 Jul 15.
To study the effect of COVID-19 on pregnancy and neonatal outcomes.
Prospective cohort study in a large tertiary maternity unit within a university hospital with an average annual birth of over 10,000 births. We prospectively collected and analysed data for a cohort of 23 pregnant patients including singleton and multiple pregnancies tested positive for COVID-19 between February 2020 and April 2020 inclusive to assess the effect of COVID-19 on pregnancy, and neonatal outcomes.
Twenty-three pregnant patients tested positive for COVID-19, delivering 20 babies including a set of twins, with four ongoing pregnancies at the time of manuscript submission. 16/23 (70 %) whom tested positive were patients from Asian (Indian sub-continent) background. The severity of the symptoms ranged from mild in 13/23 (65.2 %) of the patients, moderate in 2/23 (8.7 %), and severe in 8/23 (34.8 %). Four out of total 23 COVID-19 pregnant patients (17.4 %) developed severe adult respiratory distress syndrome complications requiring ICU support, one of whom led to maternal death 1/23 (4.3 %). 11/23 (48 %) of the patients had pre-existing co-morbidities, with morbid obesity 5/23 (21.7 %) and diabetes 4/23 (17.4 %) being the more commonly represented. Of the 23 pregnant patients 19 were in their third trimester of pregnancy and delivered; 7/19 (36.8 %) had preterm birth, 3/19 (15.8 %) developed adult respiratory distress syndrome before delivery, and 2/19 (10.5 %) had pre-eclampsia. 16/19 (84 %) of patients delivered by C-section. Out of the 20 new-borns, 18 were singletons with a set of twin.
COVID-19 is associated with high prevalence of preterm birth, preeclampsia, and caesarean section compared to non-COVID pregnancies. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.
研究 COVID-19 对妊娠和新生儿结局的影响。
在一家大学医院的大型三级妇产医院进行前瞻性队列研究,该医院的平均年分娩量超过 10000 例。我们前瞻性地收集并分析了 2020 年 2 月至 2020 年 4 月期间 23 例 COVID-19 阳性的孕妇(包括单胎和多胎妊娠)的数据,以评估 COVID-19 对妊娠和新生儿结局的影响。
23 例孕妇 COVID-19 检测呈阳性,分娩了 20 名婴儿,其中包括一对双胞胎,在提交手稿时还有 4 例妊娠继续进行。23 例阳性患者中,16 例(70%)为亚裔(印度次大陆)背景。患者症状严重程度从轻度 13 例(65.2%)到中度 2 例(8.7%),严重 8 例(34.8%)不等。23 例 COVID-19 阳性孕妇中,4 例(17.4%)出现严重成人呼吸窘迫综合征并发症,需要 ICU 支持,其中 1 例导致产妇死亡(4.3%)。23 例孕妇中,11 例(48%)有合并症,其中病态肥胖 5 例(21.7%),糖尿病 4 例(17.4%)较为常见。23 例孕妇中,19 例处于妊娠晚期并分娩;7 例(36.8%)早产,3 例(15.8%)在分娩前发生成人呼吸窘迫综合征,2 例(10.5%)发生子痫前期。19 例孕妇中,16 例(84%)行剖宫产分娩。20 例新生儿中,18 例为单胎,1 例为双胞胎。
与非 COVID 妊娠相比,COVID-19 与早产、子痫前期和剖宫产分娩的高发生率相关。未在新生儿中发现 COVID-19 感染,也未发生严重的新生儿并发症。