Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
Departamento de Medicina, Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
PLoS One. 2023 Aug 17;18(8):e0290343. doi: 10.1371/journal.pone.0290343. eCollection 2023.
The study aimed to evaluate the risk of maternal death and fetal death among pregnant women infected with SARS-CoV-2.
This is a retrospective cohort study among pregnant women with secondary data from the National Live Births System (Sistema Nacional de Nascidos Vivos), National Mortality System (Sistema Nacional de Mortalidade), and e-SUS Health Surveillance System (Sistema e-SUS Vigilância em Saúde). Pregnant women confirmed for COVID-19 had positive RT-PCR between March 2020 and May 2021, pregnant women without COVID-19 were those without notification for disease. Maternal death, fetal death, and stillbirth were assessed as primary outcomes.
We included 68,673 pregnant women not notified as suspected of COVID-19 and 1,386 with a confirmed diagnosis of COVID-19. Among pregnant women with COVID-19, 1013 (73.0%) were aged 20 to 34 years, 655 (47.2%) were brown, 907 (65.4%) had ≥ 8 years of education, in the third trimester of pregnancy (41.5%), undergoing cesarean section (64.5%). In adjusted analyses, COVID-19 in pregnancy had a higher risk of maternal death (relative risk [RR] 18.73-95% confidence interval [95%CI] 11.07-31.69), fetal death/stillbirth (RR 1.96-95%CI 1.18-3.25), preterm birth [RR 1.18-95%CI 1.01-1.39], cesarean delivery (RR 1.07-95%CI 1.02-1.11), and cesarean delivery occurring before the onset of labor (RR 1.33-95%CI 1.23-1.44).
COVID-19 may contribute to unfavorable pregnancy outcomes. Results showed that pregnant women infected with SARS-CoV-2 had a higher risk of maternal death, fetal death/stillbirth, preterm birth, cesarean delivery, and cesarean section occurring before the onset of labor.
本研究旨在评估感染 SARS-CoV-2 的孕妇的孕产妇死亡和胎儿死亡风险。
这是一项回顾性队列研究，研究对象为来自国家活产系统（Sistema Nacional de Nascidos Vivos）、国家死亡率系统（Sistema Nacional de Mortalidade）和电子卫生监测系统（Sistema e-SUS Vigilância em Saúde）的二次数据中的孕妇。2020 年 3 月至 2021 年 5 月间，确诊为 COVID-19 的孕妇进行了 RT-PCR 检测，未确诊为 COVID-19 的孕妇则没有疾病通知。孕产妇死亡、胎儿死亡和死产被评估为主要结局。
我们纳入了 68673 名未被通知疑似 COVID-19 的孕妇和 1386 名确诊 COVID-19 的孕妇。在确诊为 COVID-19 的孕妇中，1013 名（73.0%）年龄在 20 至 34 岁之间，655 名（47.2%）为棕色人种，907 名（65.4%）受教育程度≥8 年，处于妊娠晚期（41.5%），行剖宫产术（64.5%）。在调整分析中，妊娠合并 COVID-19 患者的孕产妇死亡风险更高（相对风险 [RR] 18.73-95%置信区间 [95%CI] 11.07-31.69），胎儿死亡/死产（RR 1.96-95%CI 1.18-3.25），早产（RR 1.18-95%CI 1.01-1.39），剖宫产（RR 1.07-95%CI 1.02-1.11），且剖宫产术发生在临产之前（RR 1.33-95%CI 1.23-1.44）。
COVID-19 可能导致妊娠结局不良。结果表明，感染 SARS-CoV-2 的孕妇发生孕产妇死亡、胎儿死亡/死产、早产、剖宫产和临产前行剖宫产的风险更高。
