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新冠疫情及其对有症状和无症状女性围产期结局的影响。

COVID-19 Pandemic and Its Impact on Perinatal Outcomes between Symptomatic and Asymptomatic Women.

作者信息

Babic Inas, Alsomali Faten, Aljuhani Sana, Baeissa Sahar, Alhabib Inam, AlAhmari Ebtisam, Omer Magdy, Alkhalifa Khalid

机构信息

Department of Obstetrics & Gynecology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Medical College, Alfaisal University, Riyadh, Saudi Arabia.

出版信息

Obstet Gynecol Int. 2022 Jul 14;2022:1756266. doi: 10.1155/2022/1756266. eCollection 2022.

Abstract

Coronavirus disease 2019 (COVID-19) has been increasing among pregnant women worldwide. Its impact on maternal, fetal, and neonatal health is still scarce in the published literature. As a routine COVID-19 prenatal screening has been established for all women requiring hospitalization, it is not clear whether symptomatic women carry worse pregnancy outcomes than those without symptoms. We aimed to analyze perinatal outcomes between symptomatic and asymptomatic women admitted to our center. . A single-center retrospective cohort study was conducted for fourteen months. All pregnant women with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled, and their perinatal outcomes were analyzed in two groups based on whether they were symptomatic or not. The primary outcomes were composite adverse fetal, neonatal, and maternal outcomes and their comparison between study groups. . Out of 209 included COVID-19 positive pregnant women, 62 (30%) presented with one or more infection-related symptoms. Symptomatic women were older, multiparous, carried ≥1 comorbid condition, and attained infection at earlier gestational age (44% vs. 28%; 82% vs. 69%; 28% vs. 16%; and 34 vs. 36 weeks, respectively) ( < 0.05), when compared to asymptomatic women, respectively. Maternal composite adverse outcomes were higher in the symptomatic group and showed either one or more outcomes, positive chest radiological findings, requiring hospitalization with oxygen supplementation, or maternal death (8% vs. 0.7%) ( < 0.05). Composite fetal and neonatal adverse outcomes such as miscarriage, fetal or neonatal death, admission to neonatal intensive care unit, and neonatal COVID-19 infection were not statistically significant ( > 0.05) between symptomatic and asymptomatic women. . COVID-19 infection among symptomatic pregnant women may carry a higher risk for adverse maternal outcomes. It may be associated with their advanced age and comorbid conditions. Maternal infection-associated symptoms per se likely do not pose an increased risk for adverse fetal or neonatal outcomes.

摘要

2019年冠状病毒病(COVID-19)在全球孕妇中的发病率一直在上升。已发表的文献中关于其对孕产妇、胎儿和新生儿健康影响的研究仍然很少。由于已为所有需要住院治疗的女性建立了COVID-19常规产前筛查,目前尚不清楚有症状的女性与无症状的女性相比,其妊娠结局是否更差。我们旨在分析入住本中心的有症状和无症状女性的围产期结局。开展了一项为期14个月的单中心回顾性队列研究。纳入所有严重急性呼吸综合征冠状病毒2(SARS-CoV-2)逆转录聚合酶链反应(RT-PCR)检测结果呈阳性的孕妇,并根据其是否有症状将她们的围产期结局分为两组进行分析。主要结局是胎儿、新生儿和孕产妇的综合不良结局以及研究组之间的比较。在纳入的209例COVID-19阳性孕妇中,62例(30%)出现了一种或多种与感染相关的症状。与无症状女性相比,有症状的女性年龄更大、多产、患有≥1种合并症且在更早的孕周感染(分别为44%对28%;82%对69%;28%对16%;以及34周对36周)(P<0.05)。有症状组的孕产妇综合不良结局更高,表现为出现一种或多种结局、胸部影像学检查结果阳性、需要吸氧住院或孕产妇死亡(8%对0.7%)(P<0.05)。有症状和无症状女性之间的胎儿和新生儿综合不良结局,如流产、胎儿或新生儿死亡、入住新生儿重症监护病房以及新生儿COVID-19感染,差异无统计学意义(P>0.05)。有症状的孕妇感染COVID-19可能导致孕产妇不良结局的风险更高。这可能与她们的高龄和合并症有关。孕产妇感染相关症状本身可能不会增加胎儿或新生儿不良结局的风险。

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Pregnancy and COVID-19.妊娠与 COVID-19。
Physiol Rev. 2021 Jan 1;101(1):303-318. doi: 10.1152/physrev.00024.2020. Epub 2020 Sep 24.

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