Maternal and Fetal Health Research Centre, St. Mary's Hospital, University of Manchester, 5th Floor, Oxford Road, Manchester, M13 9WL, UK.
St. Mary's Hospital, Manchester, UK.
Sci Rep. 2022 Jan 18;12(1):942. doi: 10.1038/s41598-022-04898-5.
There is conflicting evidence regarding the effect of coronavirus disease (COVID-19) in pregnancy. Risk factors for COVID-19 overlap with risk factors for pregnancy complications. We aimed to assess the effects of the COVID-19 pandemic and confirmed SARS-CoV-2 infection on pregnancy outcomes. A retrospective interrupted time-series and matched cohort analysis was performed. Singleton pregnancies completed between 1st January 2016 and 31st January 2021 were included. Trends in outcomes were analysed over time. Modelled COVID-19 transmission data were applied to deliveries since 1st January 2020 to assign a risk of COVID-19 to each pregnancy, and incorporated into a regression model of birthweight. Confirmed COVID-19 cases were matched to controls delivered in the pre-pandemic period, and maternal and neonatal outcomes compared. 43,802 pregnancies were included, with 8343 in the model of birthweight. There was no increase in the risk of stillbirth (p = 0.26) or neonatal death (p = 0.64) during the pandemic. There was no association between modelled COVID-19 attack rate (%) in any trimester and birthweight (first trimester p = 0.50, second p = 0.15, third p = 0.16). 214 COVID-positive women were matched to controls. Preterm birth was more common in symptomatic cases (14/62, 22.6%) compared to asymptomatic cases (9/109, 8.3%, p = 0.008) and controls (5/62, 8.1%, p = 0.025). Iatrogenic preterm birth was more common in cases (21/214, 9.8%) than controls (9/214, 4.2%, p = 0.02). All other examined outcomes were similar between groups. There was no significant impact of COVID-19 on the examined birth outcomes available. Symptomatic COVID-19 should be considered a risk factor for preterm birth, possibly due to an increase in iatrogenic deliveries for maternal indications.
关于冠状病毒病（COVID-19）对妊娠的影响存在相互矛盾的证据。COVID-19 的风险因素与妊娠并发症的风险因素重叠。我们旨在评估 COVID-19 大流行和确诊的 SARS-CoV-2 感染对妊娠结局的影响。进行了回顾性中断时间序列和匹配队列分析。纳入 2016 年 1 月 1 日至 2021 年 1 月 31 日期间完成的单胎妊娠。随着时间的推移分析结局趋势。自 2020 年 1 月 1 日起，将 COVID-19 传播的模型数据应用于分娩，为每一次妊娠分配 COVID-19 的风险，并将其纳入出生体重的回归模型。将确诊的 COVID-19 病例与大流行前分娩的对照组相匹配，并比较母婴和新生儿结局。共纳入 43802 例妊娠，其中 8343 例纳入出生体重模型。大流行期间，死产（p=0.26）或新生儿死亡（p=0.64）的风险无增加。在任何孕期中，模型中 COVID-19 攻击率（%）与出生体重均无关联（孕早期 p=0.50，孕中期 p=0.15，孕晚期 p=0.16）。214 例 COVID-19 阳性妇女与对照组相匹配。有症状的病例（62 例中的 14 例，22.6%）比无症状病例（109 例中的 9 例，8.3%，p=0.008）和对照组（62 例中的 5 例，8.1%，p=0.025）更常见早产。与对照组（9/214，4.2%，p=0.02）相比，病例中更常见医源性早产（21/214，9.8%）。各组之间的所有其他检查结果均相似。COVID-19 对所检查的出生结局没有显著影响。有症状的 COVID-19 应被视为早产的危险因素，可能是由于为了母亲的适应症而增加了医源性分娩。
