Campos Vanessa, Paiva Gabriela, Padron Lilian, Freitas Fernanda, Pedrotti Luana Giongo, Sun Sue Yazaki, Viggiano Maurício, Oliveira Larissa, Rohr Lucia, Madi José Mauro, Arrym Tiago Pedromônico, Oliveira Priscila, Dos Santos Esteves Ana Paula Vieira, Junior Joffre Amim, Filho Jorge Rezende, Elias Kevin M, Horowitz Neil S, Braga Antônio, Berkowitz Ross S
Department of Maternal Child, Postgraduate Program in Medical Sciences, Fluminense Federal University, Niterói, Brazil.
Department of Obstetrics and Gynaecology, Postgraduate Program in Perinatal Health, Faculty of Medicine, Maternity School of Rio de Janeiro Federal University, Rio de Janeiro, Brazil.
BJOG. 2023 Feb;130(3):292-302. doi: 10.1111/1471-0528.17313. Epub 2022 Oct 21.
To assess whether the incidence and aggressiveness of molar pregnancy (MP) and postmolar gestational trophoblastic neoplasia (GTN) changed during the COVID-19 pandemic.
Observational study with two separate designs: retrospective multicentre cohort of patients with MP/postmolar GTN and a cross-sectional analysis, with application of a questionnaire.
Six Brazilian Reference Centres on gestational trophoblastic disease.
2662 patients with MP/postmolar GTN treated from March-December/2015-2020 were retrospectively evaluated and 528 of these patients answered a questionnaire.
Longitudinal retrospective multicentre study of patients diagnosed with MP/ postmolar GTN at presentation and a cross-sectional analysis, with application of a questionnaire, exclusive to patients treated during the period of study, to assess living and health conditions during the COVID-19 pandemic compared with previous years.
The incidence of MP/postmolar GTN.
Compared with the last 5 pre-pandemic years, MP/postmolar GTN incidence remained stable during 2020 (COVID-19 pandemic). Multivariable logistic regression, adjusted for the patient age, showed that during 2020, presentation with MP was more likely to be >10 weeks of gestation (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 1.90-3.29, P < 0.001), have a pre-evacuation hCG level ≥100 000 iu/l (aOR 1.77, 95% CI 1.38-2.28, P < 0.001) and time to the initiation of chemotherapy ≥7 months (aOR 1.86, 95% CI 1.01-3.43, P = 0.047) when compared with 2015-2019.
Although the incidence of MP/postmolar GTN remained stable during the COVID-19 pandemic in Brazil, the pandemic was associated with greater gestational age at MP diagnosis and more protracted delays in initiation of chemotherapy for postmolar GTN.
评估在2019冠状病毒病大流行期间，葡萄胎（MP）和葡萄胎后妊娠滋养细胞肿瘤（GTN）的发病率及侵袭性是否发生变化。
采用两种独立设计的观察性研究：对MP/葡萄胎后GTN患者进行回顾性多中心队列研究，并应用问卷调查进行横断面分析。
巴西六个妊娠滋养细胞疾病参考中心。
对2015年3月至2020年12月期间接受治疗的2662例MP/葡萄胎后GTN患者进行回顾性评估，其中528例患者回答了问卷。
对确诊为MP/葡萄胎后GTN的患者进行纵向回顾性多中心研究，并应用仅针对研究期间接受治疗的患者的问卷调查进行横断面分析，以评估2019冠状病毒病大流行期间与前几年相比的生活和健康状况。
MP/葡萄胎后GTN的发病率。
与大流行前的最后5年相比，2020年（2019冠状病毒病大流行期间）MP/葡萄胎后GTN的发病率保持稳定。多变量逻辑回归分析，校正患者年龄后显示，2020年与2015 - 2019年相比，MP患者更可能妊娠>10周（校正比值比[aOR] 2.50，95%置信区间[CI] 1.90 - 3.29，P < 0.001），清宫前血hCG水平≥100000 iu/l（aOR 1.77，95% CI 1.38 - 2.28，P < 0.001），且开始化疗的时间≥7个月（aOR 1.86，95% CI 1.01 - 3.43，P = 0.047）。
虽然在巴西2019冠状病毒病大流行期间MP/葡萄胎后GTN的发病率保持稳定，但大流行与MP诊断时更大的孕周以及葡萄胎后GTN开始化疗的更长期延迟有关。
