Centers for Disease Control and Prevention COVID-19 Response, Epidemiology Task Force, Atlanta, Georgia, USA.
Eagle Global Scientific, LLC, Atlanta, Georgia, USA.
Birth Defects Res. 2023 Jan 15;115(2):145-159. doi: 10.1002/bdr2.2081. Epub 2022 Sep 6.
We describe clinical characteristics, pregnancy, and infant outcomes in pregnant people with laboratory-confirmed SARS-CoV-2 infection by trimester of infection.
We analyzed data from the Surveillance for Emerging Threats to Mothers and Babies Network and included people with infection in 2020, with known timing of infection and pregnancy outcome. Outcomes are described by trimester of infection. Pregnancy outcomes included live birth and pregnancy loss (<20 weeks and ≥20 weeks gestation). Infant outcomes included preterm birth (<37 weeks gestation), small for gestational age, birth defects, and neonatal intensive care unit admission. Adjusted prevalence ratios (aPR) were calculated for pregnancy and selected infant outcomes by trimester of infection, controlling for demographics.
Of 35,200 people included in this analysis, 50.8% of pregnant people had infection in the third trimester, 30.8% in the second, and 18.3% in the first. Third trimester infection was associated with a higher frequency of preterm birth compared to first or second trimester infection combined (17.8% vs. 11.8%; aPR 1.44 95% CI: 1.35-1.54). Prevalence of birth defects was 553.4/10,000 live births, with no difference by trimester of infection.
There were no signals for increased birth defects among infants in this population relative to national baseline estimates, regardless of timing of infection. However, the prevalence of preterm birth in people with SARS-CoV-2 infection in pregnancy in our analysis was higher relative to national baseline data (10.0-10.2%), particularly among people with third trimester infection. Consequences of COVID-19 during pregnancy support recommended COVID-19 prevention strategies, including vaccination.
我们描述了按感染妊娠周期分期的感染 SARS-CoV-2 的实验室确诊孕妇的临床特征、妊娠和婴儿结局。
我们分析了母婴新兴威胁监测网络的数据，纳入了 2020 年感染且已知感染和妊娠结局时间的人群。按感染妊娠周期分期描述结局。妊娠结局包括活产和妊娠丢失（<20 周和≥20 周妊娠）。婴儿结局包括早产（<37 周妊娠）、小于胎龄儿、出生缺陷和新生儿重症监护病房入住。按感染妊娠周期分期，控制人口统计学因素后，计算妊娠和选定婴儿结局的调整患病率比（aPR）。
在纳入本分析的 35200 名孕妇中，50.8%的孕妇在妊娠晚期感染，30.8%在妊娠中期感染，18.3%在妊娠早期感染。与第一或第二妊娠周期感染相比，妊娠晚期感染与早产的发生频率更高（17.8% vs. 11.8%；aPR 1.44 95%CI：1.35-1.54）。活产儿出生缺陷的发生率为 553.4/10000，与感染妊娠周期无关。
与全国基线估计值相比，本研究人群中婴儿出生缺陷的发生率没有增加的信号，无论感染的时间如何。然而，我们分析中 SARS-CoV-2 感染孕妇的早产发生率相对高于全国基线数据（10.0-10.2%），尤其是妊娠晚期感染的孕妇。妊娠期间 COVID-19 的后果支持推荐的 COVID-19 预防策略，包括接种疫苗。
