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母亲感染 COVID-19、临床特征、妊娠和新生儿结局:一项前瞻性队列研究。

Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: A prospective cohort study.

机构信息

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.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:559-562. doi: 10.1016/j.ejogrb.2020.07.008. Epub 2020 Jul 15.

Abstract

OBJECTIVE

To study the effect of COVID-19 on pregnancy and neonatal outcomes.

STUDY DESIGN

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

研究 COVID-19 对妊娠和新生儿结局的影响。

研究设计

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fef1/7362841/29443353fd0f/gr1_lrg.jpg

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