Care Delivery Research, Allina Health, Minneapolis, MN, USA.
Clinical Research Informatics and Analytics, Allina Health, Minneapolis, MN, USA.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2409360. doi: 10.1080/14767058.2024.2409360. Epub 2024 Sep 29.
This study assessed the prevalence of SARS-CoV-2 positivity in a cohort of pregnant patients served by a single health system. Treatments and outcomes are compared by maternal SARS-CoV-2 status and COVID-19 symptomatology.
This was a retrospective cohort study of patients with delivery outcomes from March 2020-December 2021. SARS-CoV-2 positivity was defined by patients who had a positive test or COVID-19 diagnosis during pregnancy. Descriptive analysis compared demographics, medical management during pregnancy, and both perinatal and non-obstetric outcomes by SARS-CoV-2/COVID-19 status (negative, positive-asymptomatic, and positive-symptomatic).
Of 24,310 pregnancies, 94.6% were negative, 3.9% were positive-asymptomatic, and 1.5% were positive-symptomatic. Non-delivery hospitalizations were highest among positive-symptomatic patients (16.8%), followed by positive-asymptomatic patients (3.9%) and lastly negative patients (2.7%) ( < 0.001). Likewise, Intensive Care Unit (ICU) admissions during an antepartum or delivery admission were higher for positive-symptomatic patients (13.0%) compared to positive-asymptomatic patients or negative patients (0.7% and 0.5%, respectively, < 0.001). The rate of preterm birth was significantly higher in positive-symptomatic patients compared to positive-asymptomatic and negative patients (15.7% vs. 9.5% and 9.8%, respectively, = 0.002). There were no statistically significant differences in rates of miscarriage or intrauterine fetal demise. Maternal readmission, administration of corticosteroids for fetal lung maturity, birthweight, and neonatal intensive care unit (NICU) admission were significantly affected by SARS-CoV-2 status.
Pregnant patients testing positive for SARS-CoV-2 were mostly asymptomatic and identified during routine screening. Symptomatic patients were significantly more likely to require hospitalization and ICU admission with some increase in adverse perinatal outcomes.
本研究评估了单一医疗系统服务的孕妇队列中 SARS-CoV-2 阳性的流行率。通过产妇 SARS-CoV-2 状态和 COVID-19 症状比较治疗和结局。
这是一项回顾性队列研究，研究对象为 2020 年 3 月至 2021 年 12 月期间分娩的患者。SARS-CoV-2 阳性的定义为孕妇在怀孕期间检测呈阳性或 COVID-19 诊断阳性。通过 SARS-CoV-2/COVID-19 状态（阴性、无症状阳性和有症状阳性）比较人口统计学特征、妊娠期间的医疗管理以及围产期和非产科结局的描述性分析。
在 24310 例妊娠中，94.6%为阴性，3.9%为无症状阳性，1.5%为有症状阳性。有症状阳性患者的非分娩住院率最高（16.8%），其次是无症状阳性患者（3.9%），最后是阴性患者（2.7%）（<0.001）。同样，在产前或分娩住院期间，有症状阳性患者的 ICU 入院率也高于无症状阳性患者或阴性患者（分别为 13.0%、0.7%和 0.5%，<0.001）。有症状阳性患者的早产率明显高于无症状阳性和阴性患者（分别为 15.7%、9.5%和 9.8%，=0.002）。流产率或宫内胎儿死亡没有统计学上的显著差异。产妇再次入院、为胎儿肺成熟而使用皮质类固醇、出生体重和新生儿重症监护病房（NICU）入院率均受到 SARS-CoV-2 状态的显著影响。
检测出 SARS-CoV-2 阳性的孕妇大多无症状，是在常规筛查中发现的。有症状的患者更有可能需要住院和 ICU 入院，围产期不良结局也有所增加。
