Vural Tayfun, Bayraktar Burak, Yildirim Karaca Suna, Odabas Ozan, Yilmaz Nisel, Samlioglu Pınar, Ozeren Mehmet
University of Health Sciences Turkey, Tepecik Training and Research Hospital, Clinic of Obstetrics and Gynecology, Izmir, Turkey.
University of Health Sciences Turkey, Tepecik Training and Research Hospital, Clinic of Clinical Microbiology, Izmir, Turkey.
Medeni Med J. 2022 Mar 18;37(1):44-53. doi: 10.4274/MMJ.galenos.2022.47600.
This study aimed to compare the postpartum outcomes of asymptomatic and symptomatic patients with coronavirus disease-2019 (COVID-19).
This retrospective cohort study included pregnant women with COVID-19. Pregnant women were categorized into two sets as asymptomatic and symptomatic according to their clinics at the time of application. COVID-19 was diagnosed using the real-time reverse transcriptase-polymerase chain reaction on the oropharyngeal and nasopharyngeal swabs. Asymptomatic and symptomatic patients were compared in terms of maternal and perinatal outcomes.
Our study population consisted of 20 asymptomatic and 41 symptomatic patients with laboratory-confirmed COVID-19. The rate of primary cesarean section was more than twice in the symptomatic group (51.2%) than that of the asymptomatic group (20%) (p=0.019). Both groups are quite similar in terms of maternal [respiratory support, COVID-19- related treatment, and intensive care unit (ICU) admission], perinatal (preterm delivery, preterm premature rupture of membrane, preeclampsia, and mode of delivery), and neonatal outcomes [birth weight, Apgar scores, neonatal ICU (NICU) admission]. The rate of total cesarean section in the asymptomatic group (75%) was statistically similar to the symptomatic group (83%) (p=0.464). The NICU admission rate was found to be similar in the asymptomatic (54.2%) and symptomatic groups (50%) (p=0.858). However, NICU admissions were more frequent in the symptomatic group due to respiratory distress (p=0.032). The breastfeeding rate is higher in the asymptomatic pregnant group as expected (p=0.015). Additionally, the ferritin level was significantly lower in the asymptomatic group (p=0.006).
The rate of primary cesarean section is quite high in symptomatic patients with COVID-19. Additionally, the total cesarean section rate was extremely high in both groups. We expected more adverse outcomes in symptomatic patients; however, we found similar maternal, perinatal, and neonatal outcomes between both groups.
本研究旨在比较新型冠状病毒肺炎（COVID-19）无症状和有症状患者的产后结局。
这项回顾性队列研究纳入了患有COVID-19的孕妇。根据就诊时的临床表现，将孕妇分为无症状和有症状两组。通过对咽拭子和鼻拭子进行实时逆转录聚合酶链反应诊断COVID-19。比较无症状和有症状患者的孕产妇和围产期结局。
我们的研究人群包括20例无症状和41例有症状且实验室确诊为COVID-19的患者。有症状组的初次剖宫产率（51.2%）是无症状组（20%）的两倍多（p=0.019）。两组在孕产妇方面（呼吸支持、COVID-19相关治疗和重症监护病房[ICU]入院）、围产期（早产、胎膜早破、子痫前期和分娩方式）以及新生儿结局（出生体重、阿氏评分、新生儿ICU[NICU]入院）方面相当相似。无症状组的总剖宫产率（75%）与有症状组（83%）在统计学上相似（p=0.464）。发现无症状组（54.2%）和有症状组（50%）的NICU入院率相似（p=0.858）。然而，由于呼吸窘迫，有症状组的NICU入院更频繁（p=0.032）。正如预期的那样，无症状孕妇组的母乳喂养率更高（p=0.015）。此外，无症状组的铁蛋白水平显著更低（p=0.006）。
COVID-19有症状患者的初次剖宫产率相当高。此外，两组的总剖宫产率都极高。我们预期有症状患者会有更多不良结局；然而，我们发现两组之间的孕产妇、围产期和新生儿结局相似。
