Universidade Federal do Rio Grande Do Norte, Health Sciences Center - Natal (RN), Brazil.
Universidade Federal do Rio Grande Do Norte, Department of Psychology - Natal (RN), Brazil.
Rev Assoc Med Bras (1992). 2023 Sep 25;69(10):e20230048. doi: 10.1590/1806-9282.20230048. eCollection 2023.
The aim of this study was to evaluate and compare Maternal Near Miss prevalence and outcomes before and during the coronavirus disease 2019 pandemic.
This retrospective study was carried out in a university maternity hospital of high complexity. The population was divided into two groups: G1, 1 year before the coronavirus disease 2019 pandemic period (August 2018-July 2019) and G2, 1 year during the pandemic period (August 2020-July 2021). All pregnant/postpartum women hospitalized up to 42 days after the end of pregnancy/childbirth were included, and pregnant women who were admitted with coronavirus disease 2019/flu symptoms were excluded. The association of variables with "Maternal Near Miss" was estimated using logistic regression.
A total of 568 women from G1 and 349 women from G2 fulfilled the Maternal Near Miss criteria. The prevalence of Maternal Near Miss in pre-pandemic was 144.1/1,000 live births and during the pandemic was 78.5/1,000 live births. In the analysis adjusted for G1, the factors of days of hospitalization (PR: 1.02, CI: 1.0-1.0, p<0.05), pre-eclampsia (PR: 0.41, CI: 1.4-2.2, p<0.05), and sepsis/severe systemic infection (PR: 1.79, CI: 0.3-0.4, p<0.05) were crucial for women with the Maternal Near Miss condition to have a greater chance of being admitted to the intensive care unit. In G2, low education (PR: 0.45, CI: 0.2-0.9, p<0.05), eclampsia (PR: 5.28, CI: 3.6-7.6, p<0.05), and use of blood products (PR: 6.48, CI: 4.7-8.8, p<0.05) increased the risk of admission to the intensive care unit.
During the pandemic, there was a lower prevalence of Maternal Near Miss in high-risk pregnancies, fewer hospitalizations, and more deaths compared to the non-pandemic period.
本研究旨在评估和比较 2019 年冠状病毒病（COVID-19）大流行前后产妇严重不良结局的患病率和结局。
本回顾性研究在一家高复杂性大学妇产医院进行。人群分为两组：G1 组为 COVID-19 大流行前 1 年（2018 年 8 月至 2019 年 7 月），G2 组为大流行期间 1 年（2020 年 8 月至 2021 年 7 月）。所有住院分娩后 42 天内的孕妇/产后妇女均被纳入研究，因 COVID-19/流感症状入院的孕妇被排除在外。采用逻辑回归估计与“产妇严重不良结局”相关的变量。
G1 组有 568 名女性和 G2 组有 349 名女性符合产妇严重不良结局标准。大流行前产妇严重不良结局的患病率为 144.1/1000 活产，大流行期间为 78.5/1000 活产。在调整 G1 后进行分析，住院天数（PR：1.02，CI：1.0-1.0，p<0.05）、子痫前期（PR：0.41，CI：1.4-2.2，p<0.05）和败血症/严重全身感染（PR：1.79，CI：0.3-0.4，p<0.05）是产妇发生严重不良结局并更有可能入住重症监护病房的关键因素。在 G2 中，低教育程度（PR：0.45，CI：0.2-0.9，p<0.05）、子痫（PR：5.28，CI：3.6-7.6，p<0.05）和血液制品的使用（PR：6.48，CI：4.7-8.8，p<0.05）增加了入住重症监护病房的风险。
与非大流行时期相比，大流行期间高危妊娠产妇严重不良结局的患病率较低，住院时间较短，死亡人数较少。
