Karasek Deborah, Baer Rebecca J, McLemore Monica R, Bell April J, Blebu Bridgette E, Casey Joan A, Coleman-Phox Kimberly, Costello Jean M, Felder Jennifer N, Flowers Elena, Fuchs Jonathan D, Gomez Anu Manchikanti, Karvonen Kayla, Kuppermann Miriam, Liang Liang, McKenzie-Sampson Safyer, McCulloch Charles E, Oltman Scott P, Pantell Matthew S, Piao Xianhua, Prather Aric A, Schmidt Rebecca J, Scott Karen A, Spellen Solaire, Stookey Jodi D, Tesfalul Martha, Rand Larry, Jelliffe-Pawlowski Laura L
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr 9 Box 2930, San Francisco, CA 94143, USA.
Lancet Reg Health Am. 2021 Oct;2:100027. doi: 10.1016/j.lana.2021.100027. Epub 2021 Jul 30.
Our understanding of the association between coronavirus disease 19 (COVID-19) and preterm or early term birth among racially and ethnically diverse populations and people with chronic medical conditions is limited.
We determined the association between COVID-19 and preterm (PTB) birth among live births documented by California Vital Statistics birth certificates between July 2020 and January 2021 (n=240,147). We used best obstetric estimate of gestational age to classify births as very preterm (VPTB, <32 weeks), PTB (< 37 weeks), early term (37 and 38 weeks), and term (39-44 weeks), as each confer independent risks to infant health and development. Separately, we calculated the joint effects of COVID-19 diagnosis, hypertension, diabetes, and obesity on PTB and VPTB.
COVID-19 diagnoses on birth certificates increased for all racial/ethnic groups between July 2020 and January 2021 and were highest for American Indian/Alaska Native (12.9%), Native Hawaiian/Pacific Islander (11.4%), and Latinx (10.3%) birthing people. COVID-19 diagnosis was associated with an increased risk of VPTB (aRR 1.6, 95% CI [1.4, 1.9]), PTB (aRR 1.4, 95% CI [1.3, 1.4]), and early term birth (aRR 1.1, 95% CI [1.1, 1.2]). There was no effect modification of the overall association by race/ethnicity or insurance status. COVID-19 diagnosis was associated with elevated risk of PTB in people with hypertension, diabetes, and/or obesity.
In a large population-based study, COVID-19 diagnosis increased the risk of VPTB, PTB, and early term birth, particularly among people with medical comorbidities. Considering increased circulation of COVID-19 variants, preventative measures, including vaccination, should be prioritized for birthing persons.
UCSF-Kaiser Department of Research Building Interdisciplinary Research Careers in Women's Health Program (BIRCWH) National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women's Health (ORWH) [K12 HD052163] and the California Preterm Birth Initiative, funded by Marc and Lynn Benioff.
我们对于2019冠状病毒病（COVID-19）与不同种族和族裔人群以及患有慢性疾病的人群中早产或早期足月分娩之间关联的了解有限。
我们确定了2020年7月至2021年1月期间加利福尼亚生命统计出生证明记录的活产中COVID-19与早产（PTB）之间的关联（n = 240,147）。我们使用最佳产科孕周估计将分娩分类为极早产（VPTB，<32周）、早产（<37周）、早期足月（37和38周）和足月（39 - 44周），因为每种情况对婴儿健康和发育都有独立风险。另外，我们计算了COVID-19诊断、高血压、糖尿病和肥胖对PTB和VPTB的联合影响。
2020年7月至2021年1月期间，所有种族/族裔群体出生证明上的COVID-19诊断都有所增加，其中美国印第安人/阿拉斯加原住民（12.9%）、夏威夷原住民/太平洋岛民（11.4%）和拉丁裔（10.3%）分娩人群的诊断率最高。COVID-19诊断与VPTB（调整后风险比[aRR] 1.6，95%置信区间[CI] [1.4, 1.9]）、PTB（aRR 1.4，95% CI [1.3, 1.4]）和早期足月分娩（aRR 1.1，95% CI [1.1, 1.2]）风险增加相关。种族/族裔或保险状况对总体关联没有效应修正。COVID-19诊断与高血压、糖尿病和/或肥胖人群的PTB风险升高相关。
在一项基于人群的大型研究中，COVID-19诊断增加了VPTB、PTB和早期足月分娩的风险，特别是在患有合并症的人群中。考虑到COVID-19变体的传播增加，应优先为分娩人群采取包括接种疫苗在内的预防措施。
加州大学旧金山分校 - 凯撒研究部妇女健康跨学科研究职业建设项目（BIRCWH）、国家儿童健康与人类发展研究所（NICHD）和妇女健康研究办公室（ORWH）[K12 HD052163]以及由马克和林恩·贝尼奥夫资助的加利福尼亚早产倡议。
