与 COVID-19 相关的孕产妇死亡：一项针对孕产妇合并症和临床特征的系统评价和荟萃分析。
Maternal death related to COVID-19: A systematic review and meta-analysis focused on maternal co-morbidities and clinical characteristics.
机构信息
Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
Dipartimento di Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Policlinico G. Martino, Università degli studi di Messina, Messina, Italy.
出版信息
Int J Gynaecol Obstet. 2021 Aug;154(2):212-219. doi: 10.1002/ijgo.13726. Epub 2021 May 18.
BACKGROUND
Besides reducing the quality of obstetric care, the direct impact of COVID-19 on pregnancy and postpartum is uncertain.
OBJECTIVE
To evaluate the characteristics of pregnant women who died due to COVID-19.
SEARCH STRATEGY
Cochrane Library, Embase, MEDLINE, Scopus, and Google Scholar were searched from inception to February 2021.
SELECTION CRITERIA
Studies that compared deceased and survived pregnant women with COVID-19.
DATA COLLECTION AND ANALYSIS
Relevant data were extracted and tabulated. The primary outcome was maternal co-morbidity.
MAIN RESULTS
Thirteen studies with 154 deceased patients were included. Obesity doubled the risk of death (relative risk [RR] 2.48, 95% confidence interval [CI] 1.41-4.36, I = 0%). No differences were found for gestational diabetes (RR 5.71; 95% CI 0.77-42.44, I = 94%) or asthma (RR 2.05, 95% CI 0.81-5.15, I = 0%). Overall, at least one severe co-morbidity showed a twofold increased risk of death (RR 2.26, 95% CI 1.77-2.89, I = 76%). Admission to intensive care was related to a fivefold increased risk of death (RR 5.09, 95% CI 2.00-12.98, I = 56%), with no difference in need for respiratory support (RR 0.53, 95% CI 0.23-1.48, I = 95%) or mechanical ventilation (RR 4.34, 95% CI 0.96-19.60, I = 58%).
CONCLUSION
COVID-19 with at least one co-morbidity increases risk of intensive care and mortality.
背景
除了降低产科护理质量外，COVID-19 对妊娠和产后的直接影响尚不确定。
目的
评估因 COVID-19 而死亡的孕妇的特征。
检索策略
从建库至 2021 年 2 月，检索 Cochrane 图书馆、Embase、MEDLINE、Scopus 和 Google Scholar。
选择标准
比较 COVID-19 死亡孕妇与存活孕妇的研究。
数据收集与分析
提取并制表相关数据。主要结局为母体合并症。
主要结果
纳入了 13 项研究共 154 例死亡患者。肥胖使死亡风险增加一倍（相对危险度 [RR] 2.48，95%置信区间 [CI] 1.41-4.36，I²=0%）。妊娠期糖尿病（RR 5.71；95%CI 0.77-42.44，I²=94%）或哮喘（RR 2.05，95%CI 0.81-5.15，I²=0%）之间未见差异。总体而言，至少有一种严重合并症使死亡风险增加两倍（RR 2.26，95%CI 1.77-2.89，I²=76%）。入住重症监护病房与死亡风险增加五倍相关（RR 5.09，95%CI 2.00-12.98，I²=56%），而对呼吸支持（RR 0.53，95%CI 0.23-1.48，I²=95%）或机械通气（RR 4.34，95%CI 0.96-19.60，I²=58%）的需求无差异。
结论
至少有一种合并症的 COVID-19 会增加入住重症监护病房和死亡的风险。
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