Division of Maternal Fetal Medicine, Ospedale Cristo Re, Università di Roma Tor Vergata, Rome, Italy.
Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia.
Acta Obstet Gynecol Scand. 2021 Jun;100(6):1034-1039. doi: 10.1111/aogs.14130. Epub 2021 Mar 9.
Our objective was to compare the fetal growth velocity and fetal hemodynamics in pregnancies complicated and in those not complicated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Prospective case-control study of consecutive pregnancies complicated by SARS-CoV-2 infection during the second half of pregnancy matched with unaffected women. The z scores of head circumference, abdominal circumference, femur length, and estimated fetal weight were compared between the two groups. Fetal growth was assessed by analyzing the growth velocity of head circumference, abdominal circumference, femur length, and estimated fetal weight between the second- and third-trimester scans. Similarly, changes in the pulsatility index of uterine, umbilical, and middle cerebral arteries, and their ratios were compared between the two study groups.
Forty-nine consecutive pregnancies complicated, and 98 not complicated, by SARS-CoV-2 infection were included. General baseline and pregnancy characteristics were similar between pregnant women with and those without SARS-CoV-2 infection. There was no difference in head circumference, abdominal circumference, femur length, and estimated fetal weight z scores between pregnancies complicated and those not complicated by SARS-CoV-2 infection at both the second- and third-trimester scans. Likewise, there was no difference in the growth velocity of all these body parameters between the two study groups. Finally, there was no difference in the pulsatility index of both maternal and fetal Doppler scans throughout gestation between the two groups.
Pregnancies complicated by SARS-CoV-2 infection are not at higher risk of developing fetal growth restriction through impaired placental function. The findings from this study do not support a policy of increased fetal surveillance in these women.
我们的目的是比较妊娠合并严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染与未合并 SARS-CoV-2 感染的孕妇的胎儿生长速度和胎儿血液动力学。
这是一项前瞻性病例对照研究，连续纳入妊娠后半期合并 SARS-CoV-2 感染的病例，并与未受影响的女性进行匹配。比较两组胎儿头围、腹围、股骨长和估计胎儿体重的 Z 评分。通过分析第二次和第三次扫描之间的头围、腹围、股骨长和估计胎儿体重的生长速度来评估胎儿生长。同样，比较两组研究中子宫、脐动脉和大脑中动脉的搏动指数及其比值的变化。
共纳入 49 例连续妊娠合并 SARS-CoV-2 感染和 98 例未合并 SARS-CoV-2 感染。合并 SARS-CoV-2 感染和未合并 SARS-CoV-2 感染的孕妇的一般基线和妊娠特征相似。第二次和第三次扫描时，合并 SARS-CoV-2 感染和未合并 SARS-CoV-2 感染的孕妇的头围、腹围、股骨长和估计胎儿体重 Z 评分均无差异。同样，两组研究中所有这些身体参数的生长速度也无差异。最后，两组在整个妊娠期间的母体和胎儿多普勒扫描的搏动指数均无差异。
妊娠合并 SARS-CoV-2 感染并不会因胎盘功能受损而增加胎儿生长受限的风险。本研究结果不支持对这些孕妇增加胎儿监测的政策。
