Marques-Fernandez Laia, Sharma Swati, Mannu Una, Chong Hsu Phern
Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom.
PLoS One. 2021 Jun 25;16(6):e0253796. doi: 10.1371/journal.pone.0253796. eCollection 2021.
Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate.
This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS.
22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001).
There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.
先前的研究表明死产率有所上升。有人认为,新冠疫情可能影响了因胎动减少而前来就诊的人数。因此,我们试图确定疫情对我们科室因胎动减少(RFM)前来就诊的人数、针对胎动减少的超声检查提供情况以及死产率的影响。
这是一项单中心回顾性队列研究,纳入了所有在2020年3月1日至2020年4月30日(新冠疫情期间)抱怨首次出现胎动减少的女性,与2019年3月1日至2019年4月30日(新冠疫情前)进行对比。数据从医院计算机记录中检索,并使用GraphPad Prism和SPSS进行统计分析。
新冠疫情前,22%(179/810)的女性首次出现胎动减少,而在新冠疫情期间这一比例为18%(145/803)(p = 0.047)。初产妇在这一人群中占比显著过高,新冠疫情期间就诊人数增加了1.4倍(67%对48%,p = 0.0005)。在新冠疫情期间,总体死产率以及出现胎动减少的女性中的死产率均未改变。超声检查的提供情况未受新冠疫情影响,按照当地指南进行的扫描比例为95%,而新冠疫情前为74%(p = 0.0001)。
在新冠疫情期间,因胎动减少而首次就诊的人数显著减少。初产妇因胎动减少前来就诊的可能性高出1.4倍。应让女性放心,新冠疫情并未导致对胎动减少的护理提供减少,也未影响死产率。