Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95125, Catania, Italy.
Department of Gynaecology and Obstetrics, San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, 36100, Vicenza, Italy.
Arch Gynecol Obstet. 2021 Jun;303(6):1483-1488. doi: 10.1007/s00404-020-05909-4. Epub 2021 Jan 3.
The coronavirus 2 (SARS-CoV-2) infection has recently spread causing millions of individuals affected globally. The raising mortality rate highlighted the necessity to identify the most susceptible populations, such as pregnant women and their fetuses, in order to protect them. Few studies have been conducted trying to identify maternal-neonatal outcomes among pregnant patients affected by COVID 19. In this scenario, this study aims to analyse poor maternal-neonatal outcomes in pregnant women affected by SARS-CoV-2 infection.
This was a double-centre, 5 months retrospective analysis conducted in Italy. The study population consisted of pregnant women with confirmed SARS-CoV-2 infection assessed by Time Quantitative Reverse Transcription PCR (qRT-PCR) nasopharyngeal swabs.
145 pregnant women affected by confirmed SARS-CoV-2 infection were included. Among them, 116 (80%) were symptomatic and 29 (20%) were asymptomatic. Up to half of the patients (n = 111; 76.5%) had a past history of respiratory disease. The mean gestational age at delivery was 36 weeks ± 5 days, while the mean maternal age was 31.5 ± 5.63. Reactive C protein (CRP) serum levels were higher than the normal range corresponding to a mean value of 56.93 ± 49.57 mg/L. The mean interval between the diagnosis of maternal COVID-19 infection and the delivery was 8.5 days. With regard to the type of delivery, the percentage of patients who delivered vaginally was higher than those who experienced a caesarean section. (74.4% vs 25.6%). The percentage of term birth was higher than preterm one (62% vs 38%). Finally, the percentages of maternal and neonatal death were found to be 5% and 6%, respectively; similarly, the percentage of the infection vertical transmission was 5%.
COVID-19 infection in pregnant women seems to negatively affect both maternal and neonatal outcomes. However, it is important to emphasize that most of the cases of maternal death occurred in patients with severe symptoms and highly altered parameters related to SARS-CoV-2 infection. In the future, larger studies are warranted in order to validate these findings.
新型冠状病毒（SARS-CoV-2）感染最近在全球范围内传播，导致数百万人受到影响。不断上升的死亡率凸显了识别最易感染人群（如孕妇及其胎儿）的必要性，以便对其进行保护。目前已有少数研究试图确定 COVID-19 感染孕妇的母婴不良结局。在此背景下，本研究旨在分析 SARS-CoV-2 感染孕妇的母婴不良结局。
这是在意大利进行的一项为期 5 个月的双中心回顾性分析。研究人群包括经鼻咽拭子实时定量逆转录 PCR（qRT-PCR）检测确诊为 SARS-CoV-2 感染的孕妇。
共纳入 145 例确诊 SARS-CoV-2 感染的孕妇。其中 116 例（80%）有症状，29 例（20%）无症状。多达一半的患者（n=111；76.5%）有既往呼吸道疾病史。分娩时的平均孕周为 36 周±5 天，平均产妇年龄为 31.5±5.63 岁。C 反应蛋白（CRP）血清水平高于正常值，平均为 56.93±49.57mg/L。产妇 COVID-19 感染与分娩的平均间隔时间为 8.5 天。在分娩方式方面，阴道分娩的患者比例高于剖宫产患者（74.4%比 25.6%）。足月产的比例高于早产（62%比 38%）。此外，产妇和新生儿死亡的比例分别为 5%和 6%，垂直传播感染的比例为 5%。
COVID-19 感染似乎对母婴结局均产生负面影响。然而，重要的是要强调，大多数产妇死亡病例发生在症状严重且与 SARS-CoV-2 感染相关的参数高度改变的患者中。未来需要开展更大规模的研究以验证这些发现。
