Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
PLoS One. 2023 Apr 20;18(4):e0284779. doi: 10.1371/journal.pone.0284779. eCollection 2023.
Throughout the COVID-19 pandemic, pregnant women have been classified as a vulnerable population. However, the evidence on the effect of infection during pregnancy on maternal and neonatal outcomes is still uncertain, and related research comprising a large population of pregnant women in Asian countries is limited. We constructed a national cohort including mothers and children (369,887 pairs) registered in the Prevention Agency-COVID-19-National Health Insurance Service (COV-N), from January 1, 2020 to March 31, 2022. We performed propensity score matchings and generalized estimation equation models to estimate the effect of COVID-19 on maternal and neonatal outcomes. In summary, we found little evidence of the effect of COVID-19 infection during pregnancy on maternal and neonatal outcomes; however, a relationship between COVID-19 infection in the second trimester and postpartum hemorrhages was discovered (Odds ratio (OR) of Delta period: 2.26, 95% Confidence intervals (CI): 1.26, 4.05). In addition, neonatal intensive care unit (NICU) admissions increased due to COVID-19 infection (pre-Delta period: 2.31, 95% CI: 1.31, 4.10; Delta period: 1.99, 95% CI: 1.47, 2.69; Omicron period: 2.36, 95% CI: 1.75, 3.18). Based on the national retrospective cohort study data, this study investigated the effects of COVID-19 infection on maternal and neonatal outcomes in Korea from the pre-Delta to the initial Omicron epidemic periods. Our evidence suggests that the timely and successful policies of the government and academia in response to COVID-19 infections in newborns in Korea may cause an increase in NICU admissions, but nonetheless, they prevent adverse maternal and neonatal outcomes simultaneously.
在整个 COVID-19 大流行期间，孕妇被归类为弱势群体。然而，关于怀孕期间感染对母婴结局的影响的证据仍不确定，而且亚洲国家相关的孕妇大人群研究有限。我们构建了一个全国性队列，包括 2020 年 1 月 1 日至 2022 年 3 月 31 日在预防署-COVID-19-国家健康保险服务（COV-N）登记的母亲和儿童（369887 对）。我们进行了倾向评分匹配和广义估计方程模型，以估计 COVID-19 对母婴结局的影响。总的来说，我们几乎没有发现 COVID-19 感染对母婴结局有影响的证据；然而，我们发现 COVID-19 在妊娠中期和产后出血之间存在关联（Delta 期的优势比（OR）：2.26，95%置信区间（CI）：1.26，4.05）。此外，由于 COVID-19 感染，新生儿重症监护病房（NICU）入院人数增加（前 Delta 期：2.31，95%CI：1.31，4.10；Delta 期：1.99，95%CI：1.47，2.69；Omicron 期：2.36，95%CI：1.75，3.18）。基于全国性回顾性队列研究数据，本研究调查了 COVID-19 感染对韩国从 Delta 前到初始 Omicron 流行期间母婴结局的影响。我们的证据表明，韩国政府和学术界针对新生儿 COVID-19 感染的及时和成功政策可能导致 NICU 入院人数增加，但同时也防止了母婴不良结局的发生。
