Department of Gynecology and Obstetrics, Women and Perinatal Health Research Group, Biomedical Research Institute (IIB-Sant Pau), Santa Creu i Sant Pau University Hospital, 08025 Barcelona, Spain.
Department of Gynecology and Obstetrics, Parc de Salut Mar University Hospital, 08003 Barcelona, Spain.
Viruses. 2021 Jan 15;13(1):112. doi: 10.3390/v13010112.
Around two percent of asymptomatic women in labor test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Spain. Families and care providers face childbirth with uncertainty. We determined if SARS-CoV-2 infection at delivery among asymptomatic mothers had different obstetric outcomes compared to negative patients. This was a multicenter prospective study based on universal antenatal screening for SARS-CoV-2 infection. A total of 42 hospitals tested women admitted for delivery using polymerase chain reaction, from March to May 2020. We included positive mothers and a sample of negative mothers asymptomatic throughout the antenatal period, with 6-week postpartum follow-up. Association between SARS-CoV-2 and obstetric outcomes was evaluated by multivariate logistic regression analyses. In total, 174 asymptomatic SARS-CoV-2 positive pregnancies were compared with 430 asymptomatic negative pregnancies. No differences were observed between both groups in key maternal and neonatal outcomes at delivery and follow-up, with the exception of prelabor rupture of membranes at term (adjusted odds ratio 1.88, 95% confidence interval 1.13-3.11; = 0.015). Asymptomatic SARS-CoV-2 positive mothers have higher odds of prelabor rupture of membranes at term, without an increase in perinatal complications, compared to negative mothers. Pregnant women testing positive for SARS-CoV-2 at admission for delivery should be reassured by their healthcare workers in the absence of symptoms.
在西班牙,约有 2%的无症状分娩妇女在 SARS-CoV-2(严重急性呼吸综合征冠状病毒 2)检测呈阳性。家属和护理人员在分娩时面临着不确定性。我们确定了无症状母亲分娩时 SARS-CoV-2 感染与阴性患者相比是否有不同的产科结局。这是一项基于 SARS-CoV-2 感染产前普遍筛查的多中心前瞻性研究。共有 42 家医院使用聚合酶链反应对 2020 年 3 月至 5 月期间入院分娩的妇女进行了检测。我们纳入了阳性母亲和一组整个产前期间无症状的阴性母亲,并进行了 6 周的产后随访。通过多变量逻辑回归分析评估了 SARS-CoV-2 与产科结局之间的关联。总共比较了 174 例无症状 SARS-CoV-2 阳性妊娠与 430 例无症状阴性妊娠。除了足月胎膜早破(调整优势比 1.88,95%置信区间 1.13-3.11; = 0.015)外,两组在分娩和随访时的关键母婴结局均无差异。与阴性母亲相比,无症状 SARS-CoV-2 阳性母亲在足月时胎膜早破的可能性更高,但围产期并发症并未增加。对于入院分娩时 SARS-CoV-2 检测呈阳性且无症状的孕妇,医护人员应让其安心。