Tekin Arzu Bilge, Yassa Murat, Birol İlter Pınar, Yavuz Emre, Önden Betül, Usta Canberk, Budak Doğuş, Günkaya Osman Samet, Çavuşoğlu Gül, Taymur Bilge Doğan, Tuğ Niyazi
University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Bahçeşehir University, VM Medical Park Maltepe Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2022 Jun 27;19(2):88-97. doi: 10.4274/tjod.galenos.2022.36937.
To present coronavirus disease-2019 (COVID-19) related maternal mortality in relation to Delta and Omicron waves and to investigate the role of lung ultrasound (LUS) in estimating mortality.
This retrospective cohort study was conducted in the obstetrics and gynecology clinic of a tertiary pandemic hospital between March 2020 and January 2022. The hospitalized pregnant women with COVID-19 diagnosis and maternal deaths were studied in relation with Delta and Omicron waves. The relationship between LUS scores of hospitalized patients and maternal mortality was explored.
Thousand and sixty-five pregnant women were hospitalized because of COVID-19 infection. Fifty-one (4.79%) of these patients had critical sickness, 96 (9.01%) of them had severe illness, 62 (5.82%) of them were admitted to the intensive care unit and 28 (2.63%) of all hospitalized pregnant women had died. Of the 1.065 patients, 783 (73.5%) were hospitalized before the Delta wave and the maternal mortality rate was 1.28% (10/783), 243 (22.8%) were hospitalized during the Delta wave and the maternal mortality rate was 7% (17/243) [relative risk (RR)=5.478, 95% confidence interval (CI) (2.54-11.8), z=4.342, p<0.001]. During the Omicron wave 39 (3.66%) patients were hospitalized and the maternal mortality rate was 2.56% (1/39). Maternal mortality rates, according to LUS scores, were 0.37% (1/273) for LUS 0, 0.72% (2/277) for LUS 1, 2.58% (10/387) for LUS 2 and 11.72% (15/128) for LUS 3 respectively (LUS 3 vs. others; maternal mortality: RR=8.447, 95% CI (4.11-17.34), z=5.814, p<0.0001). There were no vaccinated patients in the study cohort.
The maternal mortality rate was relatively high, particularly during the Delta wave at our referral center. The Delta wave, delayed vaccination and vaccine hesitancy of pregnant women might have important roles in maternal mortality. Higher LUS scores should warn clinicians of an increased risk of maternal death.
呈现与德尔塔和奥密克戎毒株流行期相关的2019冠状病毒病（COVID-19）孕产妇死亡率，并研究肺部超声（LUS）在评估死亡率中的作用。
这项回顾性队列研究于2020年3月至2022年1月在一家三级大流行医院的妇产科诊所进行。对确诊为COVID-19的住院孕妇及孕产妇死亡病例进行了与德尔塔和奥密克戎毒株流行期相关的研究。探讨了住院患者的LUS评分与孕产妇死亡率之间的关系。
1065名孕妇因COVID-19感染住院。其中51名（4.79%）病情危急，96名（9.01%）病情严重，62名（5.82%）入住重症监护病房，所有住院孕妇中有28名（2.63%）死亡。在这1065名患者中，783名（73.5%）在德尔塔毒株流行期之前住院，孕产妇死亡率为1.28%（10/783）；243名（22.8%）在德尔塔毒株流行期住院，孕产妇死亡率为7%（17/243）[相对危险度（RR）=5.478，95%置信区间（CI）（2.54 - 11.8），z = 4.342，p < 0.001]。在奥密克戎毒株流行期，有39名（3.66%）患者住院，孕产妇死亡率为2.56%（1/39）。根据LUS评分，LUS 0时孕产妇死亡率为0.37%（1/273），LUS 1时为0.72%（2/277），LUS 2时为2.58%（10/387），LUS 3时为11.
