COVID-19 大流行期间不同暴露时间和种族/族裔的早产变化。
Changes in preterm birth during the COVID-19 pandemic by duration of exposure and race and ethnicity.
机构信息
Tufts University School of Medicine, Boston, MA, USA.
Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
出版信息
J Perinatol. 2022 Oct;42(10):1346-1352. doi: 10.1038/s41372-022-01488-1. Epub 2022 Aug 16.
OBJECTIVE
We aimed to determine whether coronavirus-disease-2019 (COVID-19) pandemic exposure duration was associated with PTB and if the pandemic modified racial disparities.
STUDY DESIGN
We analyzed Philadelphia births and replicated in New Haven. Compared to matched months in two prior years, we analyzed overall PTB, specific PTB phenotypes, and stillbirth.
RESULTS
Overall, PTB was similar between periods with the following exceptions. Compared to pre-pandemic, early pregnancy (<14 weeks') pandemic exposure was associated with lower risk of PTB < 28 weeks' (aRR 0.60 [0.30-1.10]) and later exposure with higher risk (aRR 1.77 [0.78-3.97]) (interaction p = 0.04). PTB < 32 weeks' among White patients decreased during the pandemic, resulting in non-significant widening of the Black-White disparity from aRR 2.51 (95%CI: 1.53-4.16) to aRR 4.07 (95%CI: 1.56-12.01) (interaction P = 0.41). No findings replicated in New Haven.
CONCLUSION
We detected no overall pandemic effects on PTB, but potential indirect benefits for some patients which could widen disparities remains possible.
目的
我们旨在确定 2019 年冠状病毒病（COVID-19）大流行暴露持续时间是否与早产（PTB）相关，以及大流行是否改变了种族差异。
研究设计
我们分析了费城的出生数据，并在纽黑文进行了复制。与前两年的同期相比，我们分析了总体 PTB、特定 PTB 表型和死产。
结果
总体而言，两个时期的 PTB 相似，但有以下例外。与大流行前相比，妊娠早期（<14 周）大流行暴露与 28 周以下 PTB 的风险降低相关（aRR 0.60 [0.30-1.10]），而后期暴露与风险增加相关（aRR 1.77 [0.78-3.97]）（交互 P=0.04）。白人患者的 PTB <32 周在大流行期间减少，导致黑人和白人之间的差异从 aRR 2.51（95%CI：1.53-4.16）变为 aRR 4.07（95%CI：1.56-12.01）（交互 P=0.41）不再显著。纽黑文未复制到这些发现。
结论
我们没有检测到大流行对 PTB 的总体影响，但对于某些患者可能存在间接益处，这可能会扩大差异。
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