Peter Bibita, Ree NIcholas, Ferrer Karen, Younes Laila, Lepe Barbara, Manhal Khilfeh, Mydam Janardhan
Neonatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Pathology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Cureus. 2022 Mar 6;14(3):e22900. doi: 10.7759/cureus.22900. eCollection 2022 Mar.
Objective The COVID-19 pandemic is of special concern for pregnant women. A growing body of evidence suggests the virus can have a deleterious impact upon outcomes related to birth and newborn health. There is a paucity of published research demonstrating the factors that influence disease severity among those who are pregnant, while a growing body of evidence demonstrates that vertical transmission occurs. Our study investigated the impact of maternal characteristics upon COVID-19 outcomes, as well as whether disease severity impacted pregnancy outcomes. Methods We conducted a retrospective cohort study of pregnant women with COVID-19 who were admitted to two public hospitals in our state between April-August, 2020. Pregnancy outcomes and clinical, laboratory, and placental data were collected. Results Thirty-four pregnant women tested positive for SARS-CoV-2. Among them, 55% (19/34) were symptomatic. Of those who were symptomatic, 68% (13/19) presented with fever and cough. Those with symptoms had a statistically significant higher pregestational mean body mass index (BMI) compared with asymptomatic women (35.7±7.9 vs 26.7±6.9, =0.004). Screening of biochemical records demonstrated that symptomatic women had lower potassium levels compared with those who were asymptomatic (median: 3.70 mEq/L vs 4.30 mEq/L, =0.009). The lowest potassium level (3.0 mEq/L) and one of the highest BMIs (42.4 kg/m) was observed in the only case of postpartum mortality among the symptomatic women. We did not observe any influence of maternal COVID-19 severity on placental histopathology/infant health or evidence of vertical transmission. Conclusion High pregestational BMI and lower potassium levels were associated with the presence of COVID-19 symptoms among pregnant women.
新型冠状病毒肺炎（COVID-19）大流行对孕妇而言格外令人担忧。越来越多的证据表明，该病毒会对与分娩及新生儿健康相关的结局产生有害影响。虽然已发表的研究中缺乏能证明影响孕妇疾病严重程度的因素的相关内容，但越来越多的证据表明存在垂直传播现象。我们的研究调查了孕产妇特征对COVID-19结局的影响，以及疾病严重程度是否会影响妊娠结局。方法：我们对2020年4月至8月期间入住本州两家公立医院的COVID-19孕妇进行了一项回顾性队列研究。收集了妊娠结局以及临床、实验室和胎盘数据。结果：34名孕妇的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阳性。其中，55%（19/34）出现症状。在有症状的孕妇中，68%（13/19）表现出发热和咳嗽。与无症状孕妇相比，有症状孕妇的孕前平均体重指数（BMI）在统计学上显著更高（35.7±7.9 vs 26.7±6.9，P = 0.004）。生化记录筛查显示，有症状孕妇的钾水平低于无症状孕妇（中位数：3.70 mEq/L vs 4.30 mEq/L，P = 0.009）。在有症状孕妇中唯一一例产后死亡病例中，观察到了最低的钾水平（3.0 mEq/L）和最高的BMI之一（42.4 kg/m²）。我们未观察到孕产妇COVID-19严重程度对胎盘组织病理学/婴儿健康有任何影响，也未观察到垂直传播的证据。结论：孕前高BMI和低钾水平与孕妇COVID-19症状的出现有关。
