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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.

DOI:10.1002/ijgo.13726
PMID:33930185
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9087672/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/d5aa36df6615/IJGO-154-212-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/3150c906e086/IJGO-154-212-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/0bb94839e133/IJGO-154-212-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/d5aa36df6615/IJGO-154-212-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/3150c906e086/IJGO-154-212-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/0bb94839e133/IJGO-154-212-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/9087672/d5aa36df6615/IJGO-154-212-g002.jpg

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