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根据诊断孕周分析新型冠状病毒肺炎的母婴结局:一项在三级大学医院开展的横断面前瞻性研究

Maternal and Fetal Outcomes of COVID-19 According to the Trimester of Diagnosis: A Cross-Sectional Prospective Study in a Tertiary University Hospital.

作者信息

Al-Husban Naser, Di'bas Rahaf Mohammad, Karadsheh Sara Salem, Alananzeh Lara Ali, Aolymat Iman, Kilani Asma, Obeidat Ala'eddien, Alhusban Alhareth Eid, Al-Husban Hedaieh

机构信息

Department of Obstetrics and Gynecology, School of Medicine, The University of Jordan, P.O. Box 2194, Amman 11941, Jordan.

Jordan University Hospital, Amman 11942, Jordan.

出版信息

J Clin Med. 2024 Sep 5;13(17):5262. doi: 10.3390/jcm13175262.

Abstract

Pregnant women are considered a high-risk group because they may be particularly susceptible to COVID-19. Our study tried to relate fetomaternal outcomes and trimester-specific infection. A prospective study on 224 pregnant women with confirmed antenatal infections at a tertiary hospital. Data from the antenatal clinic records, admission files, labor ward and neonatal notes, lab results, respiratory consultations, and ICU admission were analyzed using Jamovi 2.2.5, with < 0.05 indicating significance. A total of 224 patients were included-10, 32, and 182 patients were diagnosed in the first, second, and third trimesters, respectively. Neonatal NICU admissions were significantly higher among those with infections in the third trimester compared to those in the first trimester ( = 0.008). Significant differences in Apgar scores at 1 and 5 min emerged between the second and third trimesters ( = 0.014 and = 0.037, respectively). However, no significant differences were observed in Apgar scores between the first and second trimesters ( = 0.341, = 0.108) or the first and third trimesters ( = 0.545, = 0.755). Complications of pregnancy, including maternal mortality and various conditions (respiratory, obstetrical, sepsis, DIC), neonatal outcomes, ICU admission, and cesarean section indications, showed no significant differences related to the trimester of infection (-values: 0.989, 0.892). Study limitations include sample size impacting generalization, higher COVID-19 cases in the third trimester than other trimesters, and potential historical data availability and accuracy issues. In the third trimester, COVID-19 caused more neonatal ICU admissions than the first trimester, with lower Apgar scores at 1 and 5 min compared to the second trimester, indicating an increasing susceptibility and vulnerability to COVID-19 infection with an increasing pregnancy age. Other fetal and maternal outcomes showed no significant differences in infection timing.

摘要

孕妇被视为高危群体,因为她们可能特别容易感染新冠病毒。我们的研究试图关联母婴结局与特定孕期感染情况。在一家三级医院对224例确诊产前感染的孕妇进行了一项前瞻性研究。使用Jamovi 2.2.5分析了产前门诊记录、入院档案、产房和新生儿病历、实验室检查结果、呼吸科会诊记录以及重症监护病房入院记录中的数据,P值<0.05表示具有统计学意义。总共纳入了224例患者,其中分别有10例、32例和182例患者在孕早期、孕中期和孕晚期被诊断感染。与孕早期感染的患者相比,孕晚期感染患者的新生儿重症监护病房入院率显著更高(P = 0.008)。孕中期和孕晚期之间1分钟和5分钟时的阿氏评分出现显著差异(分别为P = 0.014和P = 0.037)。然而,孕早期和孕中期之间(P = 0.341,P = 0.108)以及孕早期和孕晚期之间(P = 0.545,P = 0.755)的阿氏评分未观察到显著差异。妊娠并发症,包括孕产妇死亡率和各种病症(呼吸系统、产科、败血症、弥散性血管内凝血)、新生儿结局、重症监护病房入院情况以及剖宫产指征,与感染孕期均无显著差异(P值分别为0.989、0.892)。研究局限性包括样本量影响结果的普遍性、孕晚期新冠病毒感染病例多于其他孕期,以及潜在的历史数据可得性和准确性问题。在孕晚期,新冠病毒感染导致的新生儿重症监护病房入院率高于孕早期,与孕中期相比,1分钟和5分钟时的阿氏评分更低,这表明随着孕周增加,孕妇对新冠病毒感染的易感性和脆弱性增加。其他胎儿和母亲结局在感染时间方面未显示出显著差异。

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