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2020 - 2021年德尔塔变异株流行期间,新冠病毒感染孕妇对母婴结局的影响:德尔塔变异株与德尔塔变异株流行前时期的比较

Impact of COVID-19 in pregnancy on maternal and perinatal outcomes during the Delta variant period: a comparison of the Delta and pre-delta time periods, 2020-2021.

作者信息

Morris Cherrie, Doshi Harshit, Liu William Frank

机构信息

Department of OB/GYN, HealthPark/Lee Memorial Hospital, Cape Coral Hospital, 636 Del Prado Blvd S, 5th Floor Administration, Cape Coral, FL, 33990, USA.

Pediatrix Medical Group, Division of Neonatology, Golisano Children's Hospital of Southwest Florida, 3rd floor, NICU Administrative Offices, Fort Myers, FL, 33908, USA.

出版信息

Matern Health Neonatol Perinatol. 2024 Oct 1;10(1):20. doi: 10.1186/s40748-024-00189-1.

Abstract

BACKGROUND

To describe the impact on maternal and perinatal outcomes of the Delta variant of COVID-19 compared to the pre-Delta period in pregnant women with COVID-19 infections in one large public, non-profit hospital system.

METHODS

We conducted a retrospective chart review of identified COVID-19 diagnosed pregnant women with the outcome of pregnancy (livebirth or stillbirths). We assessed maternal and perinatal outcomes between the pre-delta and Delta variant time periods.

RESULTS

A study cohort of 173 mother-baby dyads was identified from January 2020 to November 2021. Maternal outcomes showed a higher rate of cesarean section (33.8%,49%; p = 0.047), with a higher frequency for worsening maternal condition due to COVID-19 (2.8%, 13.7%; p = 0.016) and association with non-reassuring fetal heart tones as indications for cesarean Sect. (53.8%, 95%; p = 0.008) during the Delta time period. There were more preterm births (16.9%, 32.4%; p = 0.023) even when excluding stillbirths (16.9%,30%; p = 0.05). Cesarean section due to "worsening maternal condition" was an independent risk factors for early delivery (β = 2.66, 93.32-62.02, p < 0.001). The neonates had a longer mean (7.1 days, 9.9 days; p < 0.001) and median (2 days, 3 days; p < 0.001) length of stay during the Delta period. There was no difference in Apgar scores, NICU admissions or need for respiratory support between time periods.

CONCLUSION

In a public, non-profit health system, from January 2020 to November of 2021, mothers with a diagnosis of COVID-19 during pregnancy, there were more preterm deliveries during the Delta time period, as well as longer length of stay for liveborn babies.

摘要

背景

描述在一家大型公立非营利性医院系统中,感染新冠病毒的孕妇感染德尔塔变异株相较于德尔塔变异株出现之前对孕产妇和围产期结局的影响。

方法

我们对确诊感染新冠病毒且有妊娠结局(活产或死产)的孕妇进行了回顾性病历审查。我们评估了德尔塔变异株出现之前和德尔塔变异株时期的孕产妇和围产期结局。

结果

从2020年1月至2021年11月确定了一个由173对母婴组成的研究队列。孕产妇结局显示剖宫产率更高(33.8%,49%;p = 0.047),因新冠病毒导致孕产妇病情恶化的频率更高(2.8%,13.7%;p = 0.016),并且在德尔塔变异株时期作为剖宫产指征与胎儿心率异常相关的比例更高(53.8%,95%;p = 0.008)。即使排除死产情况(16.9%,30%;p = 0.05),早产情况仍更多(16.9%,32.4%;p = 0.023)。因“孕产妇病情恶化”进行剖宫产是早产的独立危险因素(β = 2.66,93.32 - 62.02,p < 0.001)。在德尔塔变异株时期,新生儿的平均住院时间更长(7.1天,9.9天;p < 0.001),中位数住院时间也更长(2天,3天;p < 0.001)。不同时期的阿氏评分、新生儿重症监护病房收治情况或呼吸支持需求没有差异。

结论

在一个公立非营利性医疗系统中,2020年1月至2021年11月期间,孕期确诊感染新冠病毒的母亲,在德尔塔变异株时期早产情况更多,活产婴儿的住院时间也更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/584b/11443803/1c9cdaaae0b5/40748_2024_189_Fig1_HTML.jpg

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