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新冠病毒感染孕妇母婴垂直传播风险

Pregnancy and risk of vertical transmission in Covid-19.

机构信息

Department of Gynecology and Opbstetrics, College of Medicine, Al- Mustansiriya University, Baghdad, Iraq.

Department of Clinical Pharmacology, Medicine and Therapeutic, Al- Mustansiriya University, Baghdad, Iraq.

出版信息

J Pak Med Assoc. 2021 Dec;71(Suppl 8)(12):S137-S143.

Abstract

OBJECTIVE

The current systematic review was planned to illustrate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during pregnancy and to explore pregnancy outcomes, vertical and perinatal transmission as well as management of coronavirus disease-2019 (Covid-19) during pregnancy.

METHODS

The multidisciplinary systematic review was conducted at the Department of Clinical Pharmacology and Therapeutic Medicine, Al-Mustansiriyah University, Bagdad, Iraq. The literature search was conducted in September 2021 and included databases as Medline, PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials and Science Direct databases related to articles on pregnancy and SARS-CoV-2 infections, published between December 2019 and July 2021.

RESULTS

Of the 30 articles reviewed, 12(40%) were included. Major reasons for including a small number of studies in systematic review were that majority of the studies had insufficient description of study; analysis was duplicate across various publications, and inadequate explanation of impact of SARA-CoV-2 infection on the pregnancy outcomes. This review included 12 studies based on the assessment and estimation of risk of bias and quality of the eligible studies.

CONCLUSIONS

Findings revealed that pregnant women were predominantly susceptible to the respiratory viral infection and severe pneumonia due to physiological immune-suppression, immune adaptation and pregnancy-induced changes. The clinical presentation and management of pregnant women with Covid-19 is similar to that of non-pregnant women and there is no strong clinical evidence of vertical transmission. Also, only chloroquine and remdesivir have been found to be effective in the treatment of Covid-19 during pregnancy.

摘要

目的

本系统评价旨在阐明严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)在妊娠期的感染情况,并探讨妊娠结局、垂直及围产期传播以及妊娠期 2019 年冠状病毒病(COVID-19)的管理。

方法

该多学科系统评价在伊拉克巴格达 Al-Mustansiriyah 大学临床药理学与治疗医学系进行。文献检索于 2021 年 9 月进行,包括 Medline、PubMed、Scopus、Web of Science、Cochrane 对照试验中心注册库和 Science Direct 数据库,检索内容为与妊娠和 SARS-CoV-2 感染相关的文章,发表时间为 2019 年 12 月至 2021 年 7 月。

结果

在所审查的 30 篇文章中,有 12 篇(40%)被纳入。将少数研究纳入系统评价的主要原因是大多数研究对研究描述不足;分析在不同出版物中重复,以及对 SARS-CoV-2 感染对妊娠结局的影响的解释不足。本综述包括 12 项研究,评估和估计了纳入研究的偏倚风险和质量。

结论

研究结果表明,孕妇由于生理免疫抑制、免疫适应和妊娠引起的变化,易患呼吸道病毒感染和严重肺炎。COVID-19 孕妇的临床表现和管理与非孕妇相似,没有垂直传播的强有力临床证据。此外,只有氯喹和瑞德西韦被发现对妊娠期 COVID-19 有效。

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