Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.
Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.
Eur J Obstet Gynecol Reprod Biol. 2021 Feb;257:11-18. doi: 10.1016/j.ejogrb.2020.11.068. Epub 2020 Dec 1.
To describe the proportions of asymptomatic, mild and severe diseases in infected pregnant women admitted for delivery. To compare maternal, fetal and neonatal outcomes of SARS-CoV-2 infected pregnant women with those of non-infected patients.
Through an universal PCR testing for SARS-COV-2 at admission (not symptoms-based), this prospective cohort study enrolled all pregnant women admitted for delivery between 16th of June and the 16th of August 2020 in the West French Guiana Hospital Center.
507 pregnant women were included during the study period, of which 137 (27 %) were infected with SARS-COV-2. On admission, only 34/137 (24.8 %) of these patients presented with clinical symptoms. Among asymptomatic women, 16 /103 (15 %) became symptomatic after diagnosis. Throughout the delivery hospitalization and follow-up, 87/137 (63.5 %) remained always asymptomatic, 45/137 (32.8 %) developed a mild COVID-19 and 5/137 (3.6 %) developed a severe infection. SARS-CoV-2 infected patients were more likely to have post-partum hemorrhage >500 mL (14.2 % vs 7.2 %, RR 2.0 [95 %CI 1.1-3.4]), to be transfused (5.5 % vs 1.1 %, RR 4.9 [1.5-16.6]), and to be hospitalized in ICU (3.6 % vs 0.8 %, RR 4.5 [95 %CI 1.1-18.6] than uninfected ones. Intra-uterine fetal demises were more common in infected mothers compared to controls (5.1 % vs 1.1 %, RR 4.7 [95 % CI 1.4-45.9). Among 108 neonates from infected mothers tested at birth, none tested positive (0/108). When tested between 25 and 42 h after delivery, 4/29 (13.7 %) were positive for SARS-CoV-2 RT-PCR on nasopharyngeal swabs and remained asymptomatic.
Pregnant women admitted for delivery and diagnosed with a SARS-COV-2 infection through an universal screening were symptomatic in only a quarter of cases. Their risks of post-partum hemorrhage, transfusion and admission to ICU were higher than those of uninfected patients. They also presented a higher risk of intra-uterine fetal demise. There were no other differences in maternal, obstetrical or neonatal outcomes.
描述因分娩而住院的感染孕妇中无症状、轻症和重症疾病的比例。比较 SARS-CoV-2 感染孕妇与非感染患者的母婴、胎儿和新生儿结局。
通过普遍的 SARS-CoV-2 入院时 PCR 检测（非基于症状），本前瞻性队列研究纳入了 2020 年 6 月 16 日至 8 月 16 日期间在法属圭亚那西部医院中心分娩的所有孕妇。
在研究期间，共有 507 名孕妇纳入研究，其中 137 名（27%）感染了 SARS-CoV-2。入院时，这些患者中仅有 34/137（24.8%）出现临床症状。在无症状的女性中，16/103（15%）在诊断后出现症状。在整个分娩住院和随访期间，87/137（63.5%）一直无症状，45/137（32.8%）发展为轻度 COVID-19，5/137（3.6%）发展为重症感染。SARS-CoV-2 感染患者更有可能发生产后出血量>500mL（14.2%比 7.2%，RR 2.0[95%CI 1.1-3.4]）、需要输血（5.5%比 1.1%，RR 4.9[1.5-16.6]）和需要入住 ICU（3.6%比 0.8%，RR 4.5[95%CI 1.1-18.6]），而非感染患者。与对照组相比，感染母亲的宫内胎儿死亡更为常见（5.1%比 1.1%，RR 4.7[95%CI 1.4-45.9]）。在 108 名来自感染母亲的新生儿中，出生时进行了检测，无一人检测出阳性（0/108）。在分娩后 25-42 小时检测时，29 名新生儿中有 4 名（13.7%）鼻咽拭子 SARS-CoV-2 RT-PCR 检测阳性且无症状。
通过普遍筛查因分娩而住院并诊断为 SARS-CoV-2 感染的孕妇中，仅有四分之一出现症状。与非感染患者相比，她们产后出血、输血和入住 ICU 的风险更高。她们还存在更高的宫内胎儿死亡风险。母婴、产科或新生儿结局无其他差异。
