Hachenberg Jens, Guenther Julia, Steinkasserer Lena, Brodowski Lars, Dueppers Ansgard Lena, Delius Maria, Chiaie Loredana Delle, Lobmaier Silvia, Sourouni Marina, Richter Manuela F, Manz Jula, Parchmann Olaf, Schmidt Saskia, Winkler Jennifer, Werring Pia, Kraft Katrina, Kunze Mirjam, Manz Maike, Eichler Christian, Schaefer Viola, Berghaeuser Martin, Schlembach Dietmar, Seeger Sven, Schäfer-Graf Ute, Kyvernitakis Ioannis, Bohlmann Michael K, Ramsauer Babette, Morfeld Christine Angela, Ruediger Mario, Pecks Ulrich, von Kaisenberg Constantin
Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany.
Frauenklinik, Medizinische Hochschule Hannover, Hannover, Germany.
Z Geburtshilfe Neonatol. 2024 Feb;228(1):57-64. doi: 10.1055/a-2224-2262. Epub 2024 Feb 8.
SARS-CoV-2 is a viral disease with potentially devastating effects. Observational studies of pregnant women infected with SARS-CoV-2 report an increased risk for FGR. This study utilizes data from a prospective SARS-CoV-2 registry in pregnancy, investigating the progression of fetuses to fetal growth restriction (FGR) at birth following maternal SARS-CoV-2 and evaluating the hypothesis of whether the percentage of SGA at birth is increased after maternal SARS-CoV-2 taking into account the time interval between infection and birth.
MATERIALS & METHODS: CRONOS is a prospective German registry enrolling pregnant women with confirmed SARS-CoV-2 infection during their pregnancy. SARS-CoV-2 symptoms, pregnancy- and delivery-specific information were recorded. The data evaluated in this study range from March 2020 until August 2021. Women with SARS-CoV-2 were divided into three groups according to the time of infection/symptoms to delivery: Group I<2 weeks, Group II 2-4 weeks, and Group III>4 weeks. FGR was defined as estimated and/or birth weight<10% ile, appropriate for gestational age (AGA) was within 10 and 90%ile, and large for gestational age (LGA) was defined as fetal or neonatal weight>90%ile.
Data for a total of 2,650 SARS-CoV-2-positive pregnant women were available. The analysis was restricted to symptomatic cases that delivered after 24+0 weeks of gestation. Excluding those cases with missing values for estimated fetal weight at time of infection and/or birth weight centile, 900 datasets remained for analyses. Group I consisted of 551 women, Group II of 112 women, and Group III of 237 women. The percentage of changes from AGA to FGR did not differ between groups. However, there was a significantly higher rate of large for gestational age (LGA) newborns at the time of birth compared to the time of SARS-CoV-2 infection in Group III (p=0.0024), respectively.
FGR rates did not differ between symptomatic COVID infections occurring within 2 weeks and>4 weeks before birth. On the contrary, it presented a significant increase in LGA pregnancies in Group III. However, in this study population, an increase in the percentage of LGA may be attributed to pandemic measures and a reduction in daily activity.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种可能具有毁灭性影响的病毒性疾病。对感染SARS-CoV-2的孕妇进行的观察性研究报告称，胎儿生长受限（FGR）的风险增加。本研究利用来自一项前瞻性妊娠SARS-CoV-2登记处的数据，调查孕妇感染SARS-CoV-2后胎儿在出生时发展为胎儿生长受限的情况，并评估在考虑感染与出生之间的时间间隔后，孕妇感染SARS-CoV-2后出生时小于胎龄儿（SGA）百分比是否增加的假设。
CRONOS是一项前瞻性德国登记处，纳入孕期确诊感染SARS-CoV-2的孕妇。记录SARS-CoV-2症状、妊娠和分娩相关信息。本研究评估的数据范围为2020年3月至2021年8月。感染SARS-CoV-2的女性根据感染/症状至分娩的时间分为三组：第一组<2周，第二组2 - 4周，第三组>4周。FGR定义为估计体重和/或出生体重<第10百分位数，适于胎龄（AGA）在第10至90百分位数之间，大于胎龄（LGA）定义为胎儿或新生儿体重>第90百分位数。
共有2650例SARS-CoV-2阳性孕妇的数据可用。分析仅限于妊娠24 + 0周后分娩的有症状病例。排除那些感染时估计胎儿体重和/或出生体重百分位数缺失值的病例后，剩余900个数据集用于分析。第一组有551名女性，第二组有112名女性，第三组有237名女性。各组从AGA转变为FGR的百分比无差异。然而，第三组出生时大于胎龄新生儿的比例分别比感染SARS-CoV-2时显著更高（p = 0.0024）。
出生前2周内和>4周内发生的有症状新冠感染的FGR发生率无差异。相反，第三组中LGA妊娠显著增加。然而，在本研究人群中，LGA百分比的增加可能归因于大流行措施和日常活动的减少。
