Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, USA.
Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2022 Oct 3;75(Suppl 2):S308-S316. doi: 10.1093/cid/ciac441.
The objective was to estimate risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and assess adverse maternal and perinatal outcomes.
We used a population-based, retrospective cohort of all pregnancies with a live birth or fetal death in Florida from 1 March 2020 to 30 April 2021. Coronavirus disease 2019 (COVID-19) case reports were matched to vital registries. Outcomes assessed were risk of infection in pregnancy, preterm birth, maternal or neonatal admission to an intensive care unit (ICU), perinatal or fetal death, and maternal death. Modified Poisson and multinomial logistic regression models were used to derive relative risk estimates.
Of 234 492 women with a live birth or fetal death during the study period, 12 976 (5.5%) were identified with COVID-19 during pregnancy. Risk factors for COVID-19 in pregnancy included Hispanic ethnicity (relative risk [RR] = 1.89), Black race (RR = 1.34), being unmarried (RR = 1.04), and being overweight or obese pre-pregnancy (RR = 1.08-1.32). COVID-19 during pregnancy was associated with preterm birth (RR = 1.31), Cesarean delivery (RR = 1.04), and neonatal (RR = 1.17) and maternal (RR = 3.10) ICU admission; no association was found with increased risk of perinatal (RR = 0.72) or fetal death (RR = 0.86). Women infected during any trimester showed increased risk of preterm birth. Fourteen maternal deaths were identified among COVID-19 cases; of those who died, 12 were obese. The death rate per 10 000 was 22.09 among obese and 1.22 among non-obese gravida with COVID-19 during pregnancy (RR = 18.99, P = .001).
Obesity is a risk factor for SARS-CoV-2 infection in pregnancy and for more severe COVID-19 illness among pregnant women. SARS-CoV-2 infection is associated with preterm birth.
本研究旨在评估孕妇感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的风险，并评估不良母婴和围产儿结局。
我们使用了 2020 年 3 月 1 日至 2021 年 4 月 30 日期间佛罗里达州所有活产或胎儿死亡的基于人群的回顾性队列研究。将 2019 年冠状病毒病（COVID-19）病例报告与生命登记处相匹配。评估的结局包括妊娠期间感染风险、早产、产妇或新生儿入住重症监护病房（ICU）、围产儿或胎儿死亡以及产妇死亡。采用改良泊松和多项逻辑回归模型得出相对风险估计值。
在研究期间，234492 名活产或胎儿死亡的女性中，有 12976 名（5.5%）在妊娠期间被诊断为 COVID-19。妊娠期间感染 COVID-19 的危险因素包括西班牙裔（相对风险 [RR] = 1.89）、黑人（RR = 1.34）、未婚（RR = 1.04）和超重或肥胖（RR = 1.08-1.32）。妊娠期间 COVID-19 与早产（RR = 1.31）、剖宫产（RR = 1.04）、新生儿（RR = 1.17）和产妇（RR = 3.10）ICU 入院相关；与围产儿（RR = 0.72）或胎儿死亡（RR = 0.86）风险增加无关。妊娠任何阶段感染的女性早产风险增加。COVID-19 病例中有 14 例产妇死亡；其中 12 例肥胖。肥胖孕妇 COVID-19 期间的死亡率为每 10000 例 22.09 例，非肥胖孕妇为 1.22 例（RR = 18.99，P =.001）。
肥胖是孕妇感染 SARS-CoV-2 和孕妇 COVID-19 病情加重的危险因素。SARS-CoV-2 感染与早产有关。
