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新冠疫情如何影响母婴健康?

How Did the COVID-19 Pandemic Affect Maternal and Neonatal Health?

机构信息

Division of Neonatology, Department of Pediatrics, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training Research Center, Istanbul, Turkey.

出版信息

Am J Perinatol. 2024 May;41(S 01):e3255-e3263. doi: 10.1055/s-0043-1777717. Epub 2023 Dec 15.

Abstract

OBJECTIVE

The aim of this study was to investigate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the proportional growth of the fetus, maternal health, and neonatal outcomes.

STUDY DESIGN

The study group (Group 1) included pregnant women with a history of COVID-19. Pregnant women who were hospitalized during the same period without COVID-19 were the control group (Group 2). Maternal and neonatal outcomes were compared between the groups.

RESULTS

A total of 230 pregnant women and their infants were assessed. Group 1 ( = 74) had significantly higher rates of diabetes mellitus and hypertension than Group 2 ( = 156;  = 0.015 and 0.014, respectively). Premature birth and cesarean section rates were also significantly higher in Group 1 than in Group 2 ( = 0.001 and 0.040, respectively). While the rate of iatrogenic preterm birth was significantly higher in Group 1, the rate of spontaneous preterm birth was significantly higher in Group 2 ( = 0.049). Infants born to COVID-19-positive mothers had lower median gestational age, birth weight, and Apgar scores ( < 0.01). There was no significant difference between the groups in terms of the results of cord blood gas analysis ( > 0.05). The rate of admission to the neonatal intensive care unit (NICU) and need for mechanical ventilation was significantly higher in infants of COVID-19-positive mothers ( < 0.05 for both). The length of stay in the NICU was also significantly longer for the infants of COVID-19-positive mothers ( < 0.05). Birth weights decreased due to increased cases of iatrogenic preterm births ( < 0.05). However, ponderal indices (PIs) of newborns of pregnant COVID-19 mothers did not differ at birth ( > 0.05).

CONCLUSION

COVID-19 is associated with low Apgar scores, increased risk of premature birth complications, and maternal comorbidities, with no effect on the PI and proportionate growth of the infant at birth.

KEY POINTS

· No difference in ponderal indices.. · No difference in postnatal cardiovascular adaptation.. · COVID-19 is frequent in pregnant women with comorbidities like diabetes mellitus and hypertension..

摘要

目的

本研究旨在探讨 2019 年冠状病毒病(COVID-19)大流行对胎儿比例生长、产妇健康和新生儿结局的影响。

研究设计

研究组(第 1 组)包括有 COVID-19 病史的孕妇。同期无 COVID-19 住院的孕妇为对照组(第 2 组)。比较两组的母婴结局。

结果

共评估了 230 名孕妇及其婴儿。第 1 组(n=74)的糖尿病和高血压发生率明显高于第 2 组(n=156;分别为 0.015 和 0.014)。第 1 组早产和剖宫产率也明显高于第 2 组(分别为 0.001 和 0.040)。第 1 组医源性早产发生率明显较高,而第 2 组自发性早产发生率明显较高(分别为 0.049)。COVID-19 阳性母亲所生婴儿的中位胎龄、出生体重和阿普加评分均较低(均为 0.01)。两组脐带血气分析结果无显著差异(均为 0.05)。COVID-19 阳性母亲所生婴儿入住新生儿重症监护病房(NICU)和需要机械通气的比例明显较高(均为 0.05)。COVID-19 阳性母亲所生婴儿在 NICU 的住院时间也明显较长(均为 0.05)。由于医源性早产病例增加,导致出生体重下降(均为 0.05)。然而,COVID-19 母亲所生新生儿的体重指数(PI)在出生时无差异(均为 0.05)。

结论

COVID-19 与低阿普加评分、早产并发症风险增加以及产妇合并症相关,但对出生时婴儿的 PI 和比例生长无影响。

重点

· 体重指数无差异。· 出生后心血管适应无差异。· COVID-19 在合并糖尿病和高血压等合并症的孕妇中很常见。

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