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母亲感染冠状病毒病对早产并发症的影响。

Effect of Maternal Coronavirus Disease on Preterm Morbidities.

作者信息

Çıplak Gökçe, Becerir Cem, Sarı Fatma N, Alyamaç Dizdar Evrim

机构信息

Department of Neonatology, Neonatal Intensive Care Unit, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye.

出版信息

Am J Perinatol. 2024 May;41(S 01):e1835-e1840. doi: 10.1055/s-0043-1769471. Epub 2023 May 31.

Abstract

OBJECTIVE

Coronavirus disease (COVID-19) during pregnancy may have an impact on preterm morbidities due to the inflammatory nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Exposure to intrauterine inflammation could result in adverse consequences in preterm infants. We aimed to determine the effect of maternal coronavirus disease on preterm morbidities at a tertiary neonatal intensive care unit.

STUDY DESIGN

This observational cohort study compared the clinical outcomes of preterm infants < 37 gestational weeks with and without maternal COVID-19. The study was conducted in a tertiary-level neonatal intensive care unit between March 2020 and December 2021. Demographics and clinical data of the study groups were collected from the medical files.

RESULTS

A total of 254 infants (127 in the maternal COVID-19 group and 127 in the control group) were included in the study. Respiratory distress syndrome, early and late neonatal sepsis, intraventricular hemorrhage, patent ductus arteriosus (PDA), necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity rates were similar between groups. In the subgroup analysis, the rate of PDA was significantly higher in preterm infants ≤1,500 g with maternal SARS-CoV-2 infection (38 vs. 15%  = 0.023). Presence of maternal COVID-19 was found to be an independent predictor for PDA in very low birthweight infants, as revealed by multivariate analyses (odds ratio: 3.4; 95% confidence interval: 1.12-10.4;  = 0.031). Mortality rates and duration of hospitalization were similar in both groups.

CONCLUSION

Our results suggest that COVID-19 infection during pregnancy seems to have no adverse effect on preterm morbidities and mortality. However, maternal COVID-19 was found to be a risk factor for PDA in preterm infants ≤1,500 g.

KEY POINTS

· The effect of maternal COVID-19 on preterm morbidities still has not well defined.. · Maternal COVID-19 seems to have no adverse effect on preterm morbidities and mortality.. · The exact impact of the COVID-19 on fetal/neonatal health is yet to be clarified..

摘要

目的

由于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染具有炎症性质,孕期冠状病毒病(COVID-19)可能会对早产并发症产生影响。暴露于宫内炎症可能会给早产婴儿带来不良后果。我们旨在确定在一家三级新生儿重症监护病房中,母亲感染冠状病毒病对早产并发症的影响。

研究设计

这项观察性队列研究比较了孕周小于37周且母亲感染或未感染COVID-19的早产婴儿的临床结局。该研究于2020年3月至2021年12月在一家三级新生儿重症监护病房进行。研究组的人口统计学和临床数据从病历中收集。

结果

共有254名婴儿(母亲感染COVID-19组127名,对照组127名)纳入研究。两组间呼吸窘迫综合征、早发型和晚发型新生儿败血症、脑室内出血、动脉导管未闭(PDA)、坏死性小肠结肠炎、支气管肺发育不良和早产儿视网膜病变的发生率相似。在亚组分析中,母亲感染SARS-CoV-2的体重≤1500g的早产婴儿中PDA发生率显著更高(38%对15%,P=0.023)。多因素分析显示,母亲感染COVID-19是极低出生体重婴儿发生PDA的独立预测因素(比值比:3.4;95%置信区间:1.12 - 10.4;P=0.031)。两组的死亡率和住院时间相似。

结论

我们的结果表明,孕期感染COVID-19似乎对早产并发症和死亡率没有不良影响。然而,母亲感染COVID-19被发现是体重≤1500g的早产婴儿发生PDA的一个危险因素。

关键点

· 母亲感染COVID-19对早产并发症的影响仍未明确。· 母亲感染COVID-19似乎对早产并发症和死亡率没有不良影响。· COVID-19对胎儿/新生儿健康的确切影响尚待阐明。

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