Port-Royal Maternity Hospital, Université Paris-Cité, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, 123 Boulevard de Port Royal, Paris 75014, France; FHU PREMA (Fédération Hospitalo-Universitaire Combattre la prématurité), Université Paris-Cité, 123 Boulevard de Port Royal, Paris 75014, France.
Port-Royal Maternity Hospital, Université Paris-Cité, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, 123 Boulevard de Port Royal, Paris 75014, France; FHU PREMA (Fédération Hospitalo-Universitaire Combattre la prématurité), Université Paris-Cité, 123 Boulevard de Port Royal, Paris 75014, France.
J Gynecol Obstet Hum Reprod. 2022 Nov;51(9):102459. doi: 10.1016/j.jogoh.2022.102459. Epub 2022 Aug 15.
Recent studies suggest an association between COVID-19 infection during pregnancy and preeclampsia. Nonetheless, these studies are subject to numerous biases. We compared the onset of preeclampsia in a group with symptomatic COVID-19 during pregnancy to that in a group whose non-exposure to the virus was certain, in a center where pregnancy management was identical in both groups.
This was a single-center study comparing exposed and unexposed patients. The exposed group included pregnant women with symptomatic COVID-19 infection (diagnosed by RT-PCR or CT scan), who gave birth between March and December, 2020. The unexposed group included pregnant women who gave birth between March and December, 2019. Only cases of preeclampsia that occurred after COVID-19 infection were considered. A multivariate analysis was performed to study the existence of an association between COVID-19 and preeclampsia. A sensitivity analysis was performed among nulliparous patients.
The frequency of preeclampsia was 3.2% (3/93) in the exposed group, versus 2.2% (4/186) in the unexposed group (P = 0.58). Among the nulliparous patients, the frequency of preeclampsia was 4.9% (2/41) in the exposed group versus 0.9% (1/106) in the unexposed group (P = 0.13). The association between COVID-19 and preeclampsia was not significant after multivariate analysis (OR 3.12, 95% CI 0.39-24.6).
Symptomatic COVID-19 infection during pregnancy does not appear to increase the risk of preeclampsia strongly, although the size of our sample prevents us from reaching a conclusion about a low or moderate risk. It therefore does not appear necessary to reinforce preeclampsia screening in patients with symptomatic COVID-19 infection during pregnancy.
最近的研究表明，COVID-19 感染与孕妇子痫前期之间存在关联。然而，这些研究存在许多偏倚。我们比较了一组患有症状性 COVID-19 孕妇和另一组确定未感染病毒的孕妇的子痫前期发病情况，这些孕妇均在我们中心接受相同的妊娠管理。
这是一项单中心研究，比较了暴露组和非暴露组患者。暴露组包括 2020 年 3 月至 12 月期间诊断为 COVID-19 感染的有症状孕妇（通过 RT-PCR 或 CT 扫描诊断），而非暴露组包括 2019 年 3 月至 12 月期间分娩的孕妇。仅考虑 COVID-19 感染后发生的子痫前期病例。进行了多变量分析以研究 COVID-19 与子痫前期之间的关联。在初产妇中进行了敏感性分析。
暴露组子痫前期的发生率为 3.2%（3/93），而非暴露组为 2.2%（4/186）（P=0.58）。在初产妇中，暴露组子痫前期的发生率为 4.9%（2/41），而非暴露组为 0.9%（1/106）（P=0.13）。多变量分析后，COVID-19 与子痫前期之间的关联不显著（OR 3.12，95%CI 0.39-24.6）。
虽然我们的样本量使我们无法得出低风险或中风险的结论，但孕妇出现症状性 COVID-19 感染似乎不会显著增加子痫前期的风险。因此，对于患有症状性 COVID-19 感染的孕妇，似乎没有必要加强子痫前期的筛查。
