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2020 年 3 月 1 日至 5 月 30 日,美国 8 个医疗中心因 SARS-CoV-2 感染住院的孕妇:住院原因和妊娠特征。

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics - Eight U.S. Health Care Centers, March 1-May 30, 2020.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Sep 23;69(38):1355-1359. doi: 10.15585/mmwr.mm6938e2.

Abstract

Pregnant women might be at increased risk for severe coronavirus disease 2019 (COVID-19), possibly related to changes in their immune system and respiratory physiology* (1). Further, adverse birth outcomes, such as preterm delivery and stillbirth, might be more common among pregnant women infected with SARS-CoV-2, the virus that causes COVID-19 (2,3). Information about SARS-CoV-2 infection during pregnancy is rapidly growing; however, data on reasons for hospital admission, pregnancy-specific characteristics, and birth outcomes among pregnant women hospitalized with SARS-CoV-2 infections are limited. During March 1-May 30, 2020, as part of Vaccine Safety Datalink (VSD) surveillance of COVID-19 hospitalizations, 105 hospitalized pregnant women with SARS-CoV-2 infection were identified, including 62 (59%) hospitalized for obstetric reasons (i.e., labor and delivery or another pregnancy-related indication) and 43 (41%) hospitalized for COVID-19 illness without an obstetric reason. Overall, 50 (81%) of 62 pregnant women with SARS-CoV-2 infection who were admitted for obstetric reasons were asymptomatic. Among 43 pregnant women hospitalized for COVID-19, 13 (30%) required intensive care unit (ICU) admission, six (14%) required mechanical ventilation, and one died from COVID-19. Prepregnancy obesity was more common (44%) among pregnant women hospitalized for COVID-19 than that among asymptomatic pregnant women hospitalized for obstetric reasons (31%). Likewise, the rate of gestational diabetes (26%) among pregnant women hospitalized for COVID-19 was higher than it was among women hospitalized for obstetric reasons (8%). Preterm delivery occurred in 15% of pregnancies among 93 women who delivered, and stillbirths (fetal death at ≥20 weeks' gestation) occurred in 3%. Antenatal counseling emphasizing preventive measures (e.g., use of masks, frequent hand washing, and social distancing) might help prevent COVID-19 among pregnant women, especially those with prepregnancy obesity and gestational diabetes, which might reduce adverse pregnancy outcomes.

摘要

孕妇感染 2019 冠状病毒病(COVID-19)的重症风险可能增加,这可能与免疫系统和呼吸生理变化有关*(1)。此外,与感染 SARS-CoV-2(导致 COVID-19 的病毒)的孕妇相比,早产和死产等不良妊娠结局可能更为常见(2,3)。关于孕妇感染 SARS-CoV-2 的信息正在迅速增加;然而,关于住院原因、妊娠特有特征以及感染 SARS-CoV-2 的孕妇的分娩结局的数据有限。2020 年 3 月 1 日至 5 月 30 日,作为疫苗安全数据链(VSD)对 COVID-19 住院患者监测的一部分,发现 105 名患有 SARS-CoV-2 感染的住院孕妇,包括 62 名(59%)因产科原因(即分娩或其他与妊娠相关的指征)住院和 43 名(41%)因 COVID-19 疾病而无产科原因住院。总体而言,62 名因产科原因住院的 SARS-CoV-2 感染孕妇中,有 50 名(81%)无症状。在 43 名因 COVID-19 住院的孕妇中,13 名(30%)需要入住重症监护病房(ICU),6 名(14%)需要机械通气,1 名死于 COVID-19。与因产科原因住院的无症状孕妇(31%)相比,因 COVID-19 住院的孕妇肥胖(44%)更为常见。同样,因 COVID-19 住院的孕妇中妊娠糖尿病(26%)的发生率高于因产科原因住院的孕妇(8%)。在 93 名分娩的孕妇中,有 15%的孕妇早产,有 3%的孕妇发生死胎(妊娠 20 周以上胎儿死亡)。强调预防措施(例如戴口罩、勤洗手和保持社交距离)的产前咨询可能有助于预防孕妇感染 COVID-19,尤其是肥胖和患有妊娠糖尿病的孕妇,这可能会减少不良妊娠结局。

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