Samples Stefani, Patel Sheetal, Lee Simon, Gotteiner Nina, Patel Angira
Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 21, Chicago, IL, 60611, USA.
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Pediatr Cardiol. 2025 Feb;46(2):431-436. doi: 10.1007/s00246-024-03439-3. Epub 2024 Feb 27.
Fetal arrhythmias are rare and carry significant morbidity and mortality without appropriate treatment. Initial reports exist of fetal arrhythmia in the setting of maternal COVID-19 infection. Our study sought to evaluate incidence of fetal arrhythmia before and during the COVID-19 pandemic at our institution. This retrospective cohort study from a tertiary care fetal cardiac center utilized the institutional REDCap database to search fetal arrhythmia diagnostic codes. Medical records of mother-fetus dyads were reviewed and data were collected on diagnoses, gestational age, treatment regimen, and postnatal outcomes. Patients were divided into pre-COVID and peri-COVID segments. 8368 total pregnancies were evaluated during the 7.3 years of study period. Forty-five patients (0.5%) had a significant fetal arrhythmia and were included in this study: 19 (42%) in the pre-COVID-19 group and 26 (58%) in the peri-COVID-19 group. No patients had associated congenital heart disease. There was a notable increase in the incidence of fetal supraventricular tachycardia (SVT) (1.82 per 1000 vs 2.65 per 1000 pregnancies) and complete heart block (1.04 per 1000 vs 1.77 per 1000 pregnancies) but no apparent change in other tachyarrhythmias during the COVID era. The proportion of antibody-mediated complete heart block increased from 50 to 87.5%. There was also an increase in the percentage of SVT patients requiring postnatal treatment during COVID-19 (53.8% vs 62.5%). Our experience shows an increased incidence of some fetal arrhythmia diagnoses during the COVID-19 pandemic. Additional multi-center studies will be necessary to fully evaluate the increased burden of fetal arrhythmias during the COVID-19 era as well as to elucidate etiology.
胎儿心律失常较为罕见,若未得到恰当治疗,会导致严重的发病率和死亡率。已有关于孕妇感染新冠病毒(COVID-19)时胎儿心律失常的初步报告。我们的研究旨在评估在我们机构中,新冠疫情之前及期间胎儿心律失常的发生率。这项来自三级医疗胎儿心脏中心的回顾性队列研究利用机构的REDCap数据库搜索胎儿心律失常诊断代码。对母婴二元组的病历进行了审查,并收集了有关诊断、孕周、治疗方案和产后结局的数据。患者被分为新冠疫情前和新冠疫情期间两组。在7.3年的研究期间,共评估了8368例妊娠。45例患者(0.5%)出现明显的胎儿心律失常并纳入本研究:新冠疫情前组19例(42%),新冠疫情期间组26例(58%)。所有患者均无相关先天性心脏病。胎儿室上性心动过速(SVT)的发生率显著增加(每1000次妊娠中1.82例 vs 2.65例),完全性心脏传导阻滞的发生率也显著增加(每1000次妊娠中1.04例 vs 1.77例),但在新冠疫情期间其他快速性心律失常无明显变化。抗体介导的完全性心脏传导阻滞的比例从50%增加到87.5%。在新冠疫情期间,需要产后治疗的SVT患者比例也有所增加(53.8% vs 62.5%)。我们的经验表明,在新冠疫情期间,某些胎儿心律失常诊断的发生率有所增加。需要更多的多中心研究来全面评估新冠疫情期间胎儿心律失常增加的负担,并阐明其病因。