Zhou Fang-Yue, Li Cheng, Qin Kai-Zhou, Luo Chuan, Huang He-Feng, Wu Yan-Ting
Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China.
International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pediatr. 2023 Feb 2;11:992908. doi: 10.3389/fped.2023.992908. eCollection 2023.
Shanghai witnessed an unprecedented outbreak of COVID-19 and experienced a strict lockdown from March 28, 2022 to May 31, 2022. Most studies to date are on the first lockdown after the outbreak in December 2019. This study aimed to examine the impact of lockdown on delivery and neonatal outcomes among uninfected pregnant women in the new phase of the COVID-19 outbreak.
A retrospective analysis was conducted in the Obstetrics and Gynecology Hospital of Fudan University. Pregnant women without COVID-19 who delivered from March 28, 2022 to May 31, 2022 (lockdown group) and the same period in 2021 (non-lockdown group) were recruited for this study. Logistic regression models and 1 : 1 propensity score matching (PSM) were used to assess the effect of lockdown on delivery outcomes.
A total of 2,962 patients were included in this study, 1,339 of whom were from the lockdown group. Compared with the non-lockdown group, pregnant women giving birth during lockdown had an increased risk of term prelabor rupture of membranes (TPROM) (aOR = 1.253, 95% CI: 1.026-1.530), and decreased risks of postpartum hemorrhage (PPH) (aOR = 0.362, 95% CI: 0.216-0.606) and fetal malformation (aOR = 0.309, 95% CI: 0.164-0.582). The risk of large for gestational age (LGA) (aOR = 0.802, 95% CI: 0.648-0.992) and rate of admission to the neonatal intensive care unit (NICU) (aOR = 0.722, 95% CI: 0.589-0.885) also significantly declined. After 1 : 1 PSM, the impact of lockdown on the risk of TPROM (aOR = 1.501, 95% CI: 1.083-2.080), PPH (aOR = 0.371, 95% CI: 0.211-0.654), fetal malformation (aOR = 0.332, 95% CI: 0.161-0.684), LGA (aOR = 0.749, 95% CI: 0.594-0.945) and rate of admission to the NICU (aOR = 0.700, 95% CI: 0.564-0.869) all remained. There were no other delivery or neonatal outcomes affected by the lockdown after the COVID-19 outbreak.
This study indicated a significant increase in the risk of term PROM, significant decreases in the risk of PPH, fetal malformation and LGA, and a marked decline in the rate of admission to the NICU during Shanghai Lockdown.
上海经历了前所未有的新冠疫情爆发,并在2022年3月28日至2022年5月31日期间实施了严格封控。迄今为止,大多数研究关注的是2019年12月疫情爆发后的首次封控。本研究旨在探讨在新冠疫情新阶段,封控对未感染孕妇分娩及新生儿结局的影响。
在复旦大学附属妇产科医院进行回顾性分析。本研究纳入了2022年3月28日至2022年5月31日期间分娩的未感染新冠的孕妇(封控组)以及2021年同期分娩的孕妇(非封控组)。采用逻辑回归模型和1:1倾向得分匹配法(PSM)评估封控对分娩结局的影响。
本研究共纳入2962例患者,其中1339例来自封控组。与非封控组相比,封控期间分娩的孕妇足月胎膜早破(TPROM)风险增加(调整后比值比[aOR]=1.253,95%置信区间[CI]:1.026 - 1.530),产后出血(PPH)风险降低(aOR = 0.362,95% CI:0.216 - 0.606),胎儿畸形风险降低(aOR = 0.309,95% CI:0.164 - 0.582)。巨大儿(LGA)风险(aOR = 0.802,95% CI:0.648 - 0.992)及新生儿重症监护病房(NICU)收治率(aOR = 0.722,95% CI:0.589 - 0.885)也显著下降。经过1:1 PSM后,封控对TPROM风险(aOR = 1.501,95% CI:1.083 - 2.080)、PPH风险(aOR = 0.371,95% CI:0.211 - 0.654)、胎儿畸形风险(aOR = 0.332,95% CI:0.161 - 0.684)、LGA风险(aOR = 0.749,95% CI:0.594 - 0.945)及NICU收治率(aOR = 0.700,95% CI:0.564 - 0.869)的影响依然存在。新冠疫情爆发后,封控未对其他分娩或新生儿结局产生影响。
本研究表明,上海封控期间足月胎膜早破风险显著增加,产后出血、胎儿畸形和巨大儿风险显著降低,NICU收治率明显下降。