From the Department of Infectious Diseases and Clinical Microbiology (Akgül, Arslan); from the Department of Allergy and Immunology (Tüzer), Batman Training and Research Hospital, and from the TR Ministry of Health (Sevim), Batman Provincial Health Directorate, Batman, Turkey.
Saudi Med J. 2023 Mar;44(3):268-276. doi: 10.15537/smj.2023.44.3.20220729.
To evaluate the maternal and fetal clinical outcomes in SARS-CoV-2 infected pregnant women during the whole period of the pandemic in a single province in the southeast of Turkey.
This retrospective study included patients who were screened from the medical registration system and found to be infected with SARS-CoV-2 virus during pregnancy. The demographic, clinical, laboratory, and radiological features of all the patients were obtained and compared between groups classified as severe-critical and mild-moderate disease severity.
The mean age of all the cases was 29.0±5.3 years in the mild-moderate cases, and 30.1±5.5 years in the severe-critical cases. The rates of 3rd trimester, cesarean and premature birth, high body mass index (BMI), symptoms of cough and dyspnea, the presence of comorbidities, and hypothyroidism were significantly higher in the severe-critical cases than in the mild-moderate group. In the univariate analyses, BMI, dyspnea, cough, maternal complication rate, the neutrophil/lymphocyte ratio, the values of white blood cells, procalcitonin, high-sensitive C-reactive protein, D-dimer, ferritin, aspartate aminotransferase, and alanine aminotransferase were detected as significant risk factors. In the multivariate analysis, only procalcitonin was a significant factor.
In the 3rd trimester of pregnancy, obesity and hypothyroidism were found to be risk factors for severe-critical cases of COVID-19 infection, and the clinical course was more severe with a higher rate of mortality in the recent period of the pandemic.
评估土耳其东南部一个省份在整个大流行期间感染 SARS-CoV-2 的孕妇的母婴临床结局。
本回顾性研究纳入了从医疗登记系统中筛选出的在怀孕期间被发现感染 SARS-CoV-2 病毒的患者。获得了所有患者的人口统计学、临床、实验室和影像学特征,并在严重-危急组和轻-中度疾病严重程度组之间进行了比较。
在轻-中度组中,所有病例的平均年龄为 29.0±5.3 岁,在严重-危急组中为 30.1±5.5 岁。在严重-危急组中,第 3 孕期、剖宫产和早产、高体重指数(BMI)、咳嗽和呼吸困难症状、合并症和甲状腺功能减退的发生率明显高于轻-中度组。在单因素分析中,BMI、呼吸困难、咳嗽、母体并发症发生率、中性粒细胞/淋巴细胞比值、白细胞计数、降钙素原、高敏 C 反应蛋白、D-二聚体、铁蛋白、天门冬氨酸氨基转移酶和丙氨酸氨基转移酶被检测为显著的危险因素。在多因素分析中,只有降钙素原是一个显著的因素。
在妊娠晚期,肥胖和甲状腺功能减退被发现是 COVID-19 感染严重-危急病例的危险因素,而且在近期大流行期间,其临床过程更为严重,死亡率更高。