Dirección General, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
PLoS One. 2021 Apr 22;16(4):e0249584. doi: 10.1371/journal.pone.0249584. eCollection 2021.
The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.
SARS-CoV-2 感染的围产期后果在很大程度上仍然未知。本研究旨在描述在墨西哥城一家只收治产科相关疾病且无严重 COVID-19 的大型三级保健中心建立普遍筛查后，感染或未感染 SARS-CoV-2 的孕妇的特征和结局。这项回顾性病例对照研究整合了 2020 年 4 月 22 日至 5 月 25 日期间在墨西哥社区传播活跃期间的数据，墨西哥的 COVID-19 检测阳性率是全球最高的之一。只有通过定量 RT-PCR 检测到 SARS-CoV-2 的孕妇及其新生儿才被纳入本研究。在 240 名孕妇中，COVID-19 的患病率为 29%（95%CI，24%至 35%）；86%的患者无症状（95%CI，76%-92%），9 名患者出现轻度症状，1 名患者出现中度疾病。阳性和阴性妇女之间在感染严重程度相关的母体基线特征或危险因素方面没有差异，包括年龄>35 岁、身体质量指数（BMI）>30kg/m2 和既往疾病。两组入院时的中位妊娠周数均为 38 周。所有孕妇均无并发症出院，无孕产妇死亡报告。阳性孕妇的子痫前期比例高于阴性孕妇（18%，95%CI，10%-29%比 9%，95%CI，5%-14%，P<0.05）。其他围产期结局无差异。阳性母亲的 9 名婴儿在出生后 24 小时内检测出 SARS-CoV-2 阳性。与阴性新生儿相比，感染新生儿被送入新生儿重症监护病房（NICU）的比例更高（44%比 22%，P<0.05），住院时间更长（2[2-18]天比 2[2-3]天，P<0.001）；这些都是疾病严重程度的潜在指标。本报告强调了在高传播地区对分娩孕妇进行 COVID-19 检测的重要性。
