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回顾性分析 SARS-CoV-2(COVID-19)对妊娠和新生儿结局的影响。

Retrospective Analysis of the Impact of SARS-CoV-2 (COVID-19) on Pregnancy and Neonatal Outcomes.

机构信息

Neonatology Department Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

Obstetrics and Gynaecology Department Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

出版信息

J Pregnancy. 2024 Aug 6;2024:1177119. doi: 10.1155/2024/1177119. eCollection 2024.

Abstract

The novel coronavirus disease 2019 (COVID-19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID-19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre-eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR-proven COVID-19 infection during pregnancy on fetus and newborn. Between December 2019 and October 2021, data from pregnant women with COVID-19 symptoms or a history of contact with people with COVID-19, infected with PCR-proven COVID-19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID-19 were evaluated. Clinical and laboratory findings of newborns related to COVID-19 and mortality data related to COVID-19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853). We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty-five (56.6%) of the pregnant women had at least one COVID-19-related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID-19 infection. A total of 23 live-born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < -12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive ( = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive. While COVID-19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.

摘要

2019 年新型冠状病毒病(COVID-19)在合并症患者中更为严重,如高龄和免疫功能低下。另一组受 COVID-19 影响的是孕妇。怀孕期间的免疫变化以及怀孕期间出现的妊娠糖尿病和子痫前期等情况也会对胎儿产生影响。本研究旨在分析经 PCR 证实的 COVID-19 感染在怀孕期间对胎儿和新生儿的影响。

2019 年 12 月至 2021 年 10 月,回顾性分析了有 COVID-19 症状或与 COVID-19 患者接触史、经 PCR 证实感染 COVID-19 病毒的孕妇的临床和实验室数据。分析了孕妇的死亡数据。记录了与 COVID-19 相关的新生儿的临床和实验室发现以及与 COVID-19 相关的死亡率数据。该研究得到了加济安泰普亚萨尔吉勒培训和研究医院伦理委员会的批准(2021 年 09 月 07 日/853)。

我们评估了在我院接受随访并分娩为活产、死产、流产或刮宫的 327 名孕妇。185 名(56.6%)孕妇至少有 1 项与 COVID-19 相关的症状。我们评估了 306 例活产、21 例宫内胎儿死亡和 13 例产后死亡的数据。在产后死亡中,有 5 名婴儿因 COVID-19 感染直接死亡。共有 23 名(7.5%)活产婴儿被归类为小于胎龄儿(SGA),80 名(26.1%)婴儿在 37 周前分娩,32 名(10.4%)婴儿在 32 周前分娩。脐血血气分析显示,有 19 名婴儿(6.3%)pH 值<7,碱剩余(BE)<-12。未存活母亲所生婴儿的围产期窒息发生率明显更高(=0.027)。有相当数量的婴儿,119 名(40.3%)入住新生儿重症监护病房(NICU)。在入住 NICU 的 7 名 PCR 阳性婴儿中,有 5 名(4.2%)未存活。

虽然 COVID-19 感染在怀孕期间严重影响孕妇的死亡率和发病率,但它也会导致胎儿的死亡率和发病率。

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