Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden.
Acta Obstet Gynecol Scand. 2023 Jun;102(6):681-689. doi: 10.1111/aogs.14552. Epub 2023 Mar 17.
Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID-19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with severe COVID-19.
We identified pregnant women admitted to ICU in Sweden (n = 96), Norway (n = 31), and Denmark (n = 16) because of severe COVID-19, from national registers and clinical databases between March 2020 and February 2022 (Denmark), August 2022 (Sweden), or December 2022 (Norway). Their background characteristics, pregnancy outcome, and vaccination status were compared with all birthing women and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test-positive pregnant women during the same time period. We calculated the number admitted to ICU per 10 000 birthing and per 1000 SARS-CoV-2 test-positive women during the Index, Alpha, Delta, and Omicron periods.
Women admitted to ICU had a higher mean body mass index, were more often of non-Scandinavian origin, had on average lower education and income levels, had a higher proportion of chronic and pregnancy-related conditions, delivered preterm, had neonates with low Apgar scores, and had more infants admitted to neonatal care, compared with all birthing and test-positive pregnant women. Of those admitted to ICU, only 7% had been vaccinated before admission. Overall, the highest proportion of women admitted to ICU per birthing was during the Delta period (4.1 per 10 000 birthing women). In Norway, the highest proportion admitted to ICU per test-positive pregnant women was during the Delta period (17.8 per 1000 test-positive), whereas the highest proportion of admitted per test-positive in Sweden and Denmark was seen during the Index period (15.4 and 8.9 per 1000 test-positive, respectively).
Admission to ICU because of COVID-19 in pregnancy was a rare event in the Scandinavian countries, but women who were unvaccinated, of non-Scandinavian origin, and with lower socio-economic status were at higher risk of admission to ICU. In addition, women admitted to ICU for COVID-19 had higher risk of adverse pregnancy outcomes.
妊娠是严重 2019 年冠状病毒病（COVID-19）和不良妊娠结局的危险因素。我们旨在探讨重症 COVID-19 住院孕妇的母体特征、妊娠结局、疫苗接种情况和病毒变异。
我们从瑞典（n=96）、挪威（n=31）和丹麦（n=16）的国家登记处和临床数据库中确定了 2020 年 3 月至 2022 年 2 月期间（丹麦）、2022 年 8 月（瑞典）或 2022 年 12 月（挪威）因 COVID-19 住进 ICU 的孕妇。比较了这些患者的背景特征、妊娠结局和疫苗接种情况，与同期所有分娩妇女和 SARS-CoV-2 检测阳性孕妇进行比较。我们计算了指数、Alpha、Delta 和 Omicron 期间，每 10000 名分娩妇女和每 1000 名 SARS-CoV-2 检测阳性孕妇中住进 ICU 的人数。
住进 ICU 的女性平均 BMI 较高，非斯堪的纳维亚裔的比例更高，平均受教育程度和收入水平较低，患有慢性和妊娠相关疾病的比例较高，早产，新生儿 Apgar 评分较低，新生儿需要入住新生儿重症监护病房的比例较高。与所有分娩和检测阳性的孕妇相比，住进 ICU 的患者中，仅有 7%的人在住院前接种过疫苗。总体而言，Delta 期间每 10000 名分娩妇女住进 ICU 的人数最多（4.1 人）。在挪威，Delta 期间每 1000 名检测阳性孕妇中住进 ICU 的人数最多（17.8 人），而瑞典和丹麦的检测阳性患者中住进 ICU 的比例最高，分别为指数期间（15.4 和 8.9 人）。
在斯堪的纳维亚国家，妊娠期间因 COVID-19 住进 ICU 是一种罕见事件，但未接种疫苗、非斯堪的纳维亚裔和社会经济地位较低的女性住进 ICU 的风险更高。此外，因 COVID-19 住进 ICU 的孕妇不良妊娠结局的风险更高。
