COVID-19 孕期通用检测政策：系统评价。
Universal Testing Policy for COVID-19 in Pregnancy: A Systematic Review.
机构信息
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia.
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia.
出版信息
Front Public Health. 2022 Feb 8;10:588269. doi: 10.3389/fpubh.2022.588269. eCollection 2022.
BACKGROUND
The coronavirus disease (COVID-19) has spread at an accelerated rate. WHO reported that in the general population, the majority are either asymptomatic or mildly infected. In view of the high risk of SARS-CoV-2 transmission from a pregnant woman to her newborn, healthcare workers and other patients, it is a raised concern whether universal testing should be implemented in this targeted population. The current guidelines have not recommended a universal testing policy. In certain European countries, however, the policy was implemented by some hospitals in regions with high prevalence of COVID-19 infection.
AIMS
To assess the justification for universal screening of pregnant women for COVID-19 prior to admission in labor through systematic review of antenatal prevalence of asymptomatic infection, hence risk of inadvertent spread of infection.
MATERIALS AND METHODS
Three databases confined to PubMed, Ovid and Science Direct were used to search for articles from November 2019 onwards published in the English language. The search was conducted using the keywords "COVID-19" or "coronavirus" or "SARS-CoV-2" and "pregnancy" or "pregnant" or "obstetric" or "labor" and "universal" or "testing" or "prevalence". The review was registered with PROSPERO.
RESULTS
The search result retrieved 34 studies, with the majority consisting of retrospective cohort studies, while other studies such as prospective cohort study, research letters and a case series were also identified. A total of 19,958 pregnant women were universally tested until the date of report. Overall, the prevalence of universal testing among pregnant women presenting to labor and delivery units are higher in Western regions. From the total number of pregnant women 5.3% tested positive and among these, the majority (75.5%) did not manifest any symptoms at the time of testing.
CONCLUSION
In areas with high prevalence of COVID-19 infection, the implementation of a universal testing policy among pregnant women presenting to labor and admission units may be cost effective in helping to curb disease transmission.
SYSTEMATIC TRIAL REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020184248, PROSPERO: CRD42020184248.
背景
冠状病毒病（COVID-19）的传播速度加快。世界卫生组织报告称，在普通人群中，大多数人无症状或轻度感染。鉴于 COVID-19 从孕妇传播给新生儿、医护人员和其他患者的风险较高，是否应在这一特定人群中实施普遍检测引起了关注。目前的指南并未建议实施普遍检测政策。然而，在某些欧洲国家，一些医院在 COVID-19 感染高发地区实施了这一政策。
目的
通过系统综述产前无症状感染的患病率，评估对临产孕妇进行 COVID-19 普遍筛查的合理性，从而评估感染无意中传播的风险。
材料和方法
我们使用限定在 PubMed、Ovid 和 Science Direct 的三个数据库，对 2019 年 11 月以来发表的英文文章进行了检索。检索使用了“COVID-19”或“冠状病毒”或“SARS-CoV-2”和“妊娠”或“孕妇”或“产科”或“分娩”以及“普遍”或“检测”或“患病率”等关键词。该综述已在 PROSPERO 上注册。
结果
检索结果共检索到 34 项研究，其中大多数为回顾性队列研究，也有前瞻性队列研究、研究信函和病例系列等其他研究。共有 19958 名孕妇接受了普遍检测，截至报告日期。总体而言，在 COVID-19 感染高发地区，临产和分娩单位孕妇的普遍检测率较高。在总共接受检测的孕妇中，有 5.3%的检测结果为阳性，其中大多数（75.5%）在检测时没有任何症状。
结论
在 COVID-19 感染高发地区，对临产和入院的孕妇实施普遍检测政策，可能有助于控制疾病传播，具有成本效益。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020184248，PROSPERO：CRD42020184248。
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