Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2024 May;32(5):969-978. doi: 10.1002/oby.23998. Epub 2024 Feb 13.
The objective of this study is to determine whether in utero exposure to SARS-CoV-2 is associated with increased risk for a cardiometabolic diagnosis by 18 months of age.
This retrospective electronic health record (EHR)-based cohort study included the live-born offspring of all individuals who delivered during the COVID-19 pandemic (April 1, 2020-December 31, 2021) at eight hospitals in Massachusetts. Offspring exposure was defined as a positive maternal SARS-CoV-2 polymerase chain reaction test during pregnancy. The primary outcome was presence of an ICD-10 code for a cardiometabolic disorder in offspring EHR by 18 months. Weight-, length-, and BMI-for-age z scores were calculated and compared at 6-month intervals from birth to 18 months.
A total of 29,510 offspring (1599 exposed and 27,911 unexposed) were included. By 18 months, 6.7% of exposed and 4.4% of unexposed offspring had received a cardiometabolic diagnosis (crude odds ratio [OR] 1.47 [95% CI: 1.10 to 1.94], p = 0.007; adjusted OR 1.38 [1.06 to 1.77], p = 0.01). Exposed offspring had a significantly greater mean BMI-for-age z score versus unexposed offspring at 6 months (z score difference 0.19 [95% CI: 0.10 to 0.29], p < 0.001; adjusted difference 0.04 [-0.06 to 0.13], p = 0.4).
Exposure to maternal SARS-CoV-2 infection was associated with an increased risk of receiving a cardiometabolic diagnosis by 18 months preceded by greater BMI-for-age at 6 months.
本研究旨在确定胎儿在子宫内暴露于 SARS-CoV-2 是否会增加 18 个月时心血管代谢诊断的风险。
这是一项基于电子病历（EHR）的回顾性队列研究，纳入了马萨诸塞州 8 家医院在 COVID-19 大流行期间（2020 年 4 月 1 日至 2021 年 12 月 31 日）分娩的所有活产儿。胎儿暴露定义为母亲在怀孕期间 SARS-CoV-2 聚合酶链反应检测阳性。主要结局是在 18 个月时，后代的 EHR 中存在 ICD-10 编码的心血管代谢障碍。从出生到 18 个月，每 6 个月计算并比较体重、身长和 BMI 年龄 z 分数。
共纳入 29510 名后代（1599 名暴露组和 27911 名未暴露组）。18 个月时，暴露组有 6.7%的后代和 4.4%的未暴露组后代接受了心血管代谢诊断（粗比值比 [OR] 1.47 [95%CI：1.10 至 1.94]，p=0.007；调整 OR 1.38 [1.06 至 1.77]，p=0.01）。与未暴露组相比，暴露组后代在 6 个月时的平均 BMI 年龄 z 评分显著更高（z 评分差值 0.19 [95%CI：0.10 至 0.29]，p<0.001；调整差值 0.04 [-0.06 至 0.13]，p=0.4）。
暴露于母体 SARS-CoV-2 感染与 18 个月时接受心血管代谢诊断的风险增加相关，这一风险在 6 个月时就已经表现出更大的 BMI 年龄。
