Grobeisen-Duque Orly, Villavicencio-Carrisoza Oscar, Mora-Vargas Carlos Daniel, Arteaga-Lopez Carolina Penelope, Martinez-Salazar Maria Guadalupe, Rosas-Balan Alejandro, Leon-Juarez Moises, Flores-Herrera Hector, Zaga-Clavellina Veronica, Aguilera-Arreola Ma Guadalupe, Helguera-Repetto Addy Cecilia
Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico, Mexico.
Escuela Nacional de Ciencias Biologicas del Instituto Politecnico Nacional, Ciudad de Mexico, Mexico.
Front Med (Lausanne). 2024 Oct 15;11:1458719. doi: 10.3389/fmed.2024.1458719. eCollection 2024.
The COVID-19 pandemic caused widespread changes in healthcare delivery, particularly affecting vulnerable populations such as pregnant adolescents. These patients faced additional challenges, including developmental and gestational changes, stress from isolation, and altered healthcare access, which may have impacted the incidence and prevalence of maternal and neonatal complications. This study aims to compare maternal and neonatal outcomes in adolescent pregnancies before and during the pandemic, focusing on how shifts in healthcare delivery influenced these outcomes.
A retrospective cohort study was conducted, including 340 adolescent pregnant patients who received prenatal care at a tertiary care institution. Patients were divided into two groups: pre-pandemic ( = 209) and pandemic ( = 131). Maternal data, including pre-BMI and gestational weight gain (GWG), were collected to evaluate maternal and neonatal outcomes. Statistical analysis was performed using chi-square tests, Fisher's exact tests, and odds ratio (OR) calculations.
The pandemic group showed a statistically significant increase in cesarean deliveries ( = 0.002; OR = 1.99) and cervicovaginitis, particularly caused by Ureaplasma spp. Conversely, the pre-pandemic group had higher rates of psychoactive substance use, maternal urinary tract infections, and neonatal transient tachypnea. In the pandemic group, overweight pre-gestational BMI and cervicovaginitis were more prevalent in patients with adequate GWG, while inadequate GWG was associated with an increased risk of urinary tract infection (UTI). A significant association between pre-gestational overweight/obesity and excessive GWG was also observed ( < 0.05).
The COVID-19 pandemic altered both healthcare delivery and maternal and neonatal outcomes in adolescent pregnancies. Changes in healthcare access, isolation, and shifts in medical management during the pandemic resulted in higher cesarean rates and infection rates among pregnant adolescents. These findings underscore the need for adaptable, resilient healthcare systems capable of maintaining comprehensive care even in the face of global crises. Further studies are needed to explore long-term effects on adolescent maternal and neonatal health.
新冠疫情导致医疗服务提供方式发生广泛变化，尤其对怀孕青少年等弱势群体产生影响。这些患者面临额外挑战，包括发育和孕期变化、隔离带来的压力以及医疗服务获取的改变，这可能影响了孕产妇和新生儿并发症的发生率及患病率。本研究旨在比较疫情前和疫情期间青少年怀孕的孕产妇和新生儿结局，重点关注医疗服务提供方式的转变如何影响这些结局。
开展了一项回顾性队列研究，纳入340名在三级医疗机构接受产前护理的青少年怀孕患者。患者分为两组：疫情前组（n = 209）和疫情组（n = 131）。收集包括孕前体重指数（BMI）和孕期体重增加（GWG）在内的孕产妇数据，以评估孕产妇和新生儿结局。使用卡方检验、费舍尔精确检验和比值比（OR）计算进行统计分析。
疫情组剖宫产率有统计学显著增加（P = 0.002；OR = 1.99），宫颈炎尤其是由解脲脲原体引起的宫颈炎发生率增加。相反，疫情前组精神活性物质使用、孕产妇尿路感染和新生儿短暂性呼吸急促的发生率更高。在疫情组中，孕前BMI超重和宫颈炎在GWG充足的患者中更普遍，而GWG不足与尿路感染（UTI）风险增加相关。还观察到孕前超重/肥胖与GWG过多之间存在显著关联（P < 0.05）。
新冠疫情改变了青少年怀孕的医疗服务提供方式以及孕产妇和新生儿结局。疫情期间医疗服务获取的变化、隔离以及医疗管理的转变导致怀孕青少年的剖宫产率和感染率升高。这些发现强调需要有适应能力、有韧性的医疗系统，即使面对全球危机也能维持全面护理。需要进一步研究以探讨对青少年孕产妇和新生儿健康的长期影响。
