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分娩前由新冠病毒引起的发热会增加羊水粪染率并影响母婴结局吗?

Does Fever Caused by the COVID-19 Virus Before Labor Increase the Rate of MSAF and Affect Maternal and Fetal Outcomes?

作者信息

Feng Runrun, Tao Yu, Sun Haiyan, Cao Cen, Gu Hairong, Hu Junmei, Chang Wenwen, Li Xia, Jiang Ziyan

机构信息

Department of Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210036, China.

Department of Obstetrics, Taixing People's Hospital, Taizhou 225400, Jiangsu, China.

出版信息

Can J Infect Dis Med Microbiol. 2024 Nov 11;2024:8456910. doi: 10.1155/2024/8456910. eCollection 2024.

Abstract

The main objective of this study is to investigate whether there is a difference in the occurrence of MSAF between fever and nonfever-pregnant women during the COVID-19 pandemic. We conducted a multicenter retrospective study including pregnant women during the COVID-19 pandemic. Among the 400 pregnant women included in the final data analysis, 238 had fever during delivery, while 162 nonfever-pregnant women met the inclusion and exclusion criteria and served as controls. We collected various obstetric and neonatal parameters for both groups of patients, compared, and statistically tested the significance of these parameters. For parameters with significant statistical differences and clinical significance, we performed logistic regression analysis to explore potential risk factors for MSAF. In a sample of 400 parturients, a total of 69 individuals (17.25%) were discovered to have MSAF with the prevalence increasing to 21.85% in the fever population. A statistically significant association was observed between fever during pregnancy and MSAF, with a higher risk of development observed in fever-pregnant women compared to nonfever ones. Specifically, the odds of developing MSAF increased by a factor of 0.979 in fever-pregnant women compared to nonfever ones, as determined by a logistic regression model (OR = 1.979, 95% CI = 1.061∼3.693, =0.032). Moreover, pregnant women with COVID-19 infection had a significantly higher risk of developing MSAF, with the odds increasing by a factor of 2.567 compared to uninfected pregnant women (OR = 3.567, 95% CI = 1.622∼7.845, =0.002). In addition, the study also identified abnormal fetal heart monitoring ( < 0.05) and gestational age ( < 0.05) as independent risk factors for the occurrence of MSAF. For pregnant women infected with COVID-19, the rate of MSAF disturbance significantly increases, therefore, it is necessary to pay more attention to fetal heart changes and amniotic fluid conditions, and actively managing labor is beneficial for improving delivery outcomes.

摘要

本研究的主要目的是调查在新冠疫情期间,发热与未发热孕妇发生羊水胎粪污染(MSAF)的情况是否存在差异。我们开展了一项多中心回顾性研究,纳入新冠疫情期间的孕妇。在最终数据分析纳入的400名孕妇中,238名在分娩时发热,而162名未发热孕妇符合纳入和排除标准并作为对照。我们收集了两组患者的各种产科和新生儿参数,进行比较并对这些参数的显著性进行统计学检验。对于具有显著统计学差异和临床意义的参数,我们进行了逻辑回归分析以探索MSAF的潜在危险因素。在400名产妇样本中,共发现69例(17.25%)发生MSAF,发热人群中的患病率增至21.85%。观察到孕期发热与MSAF之间存在统计学显著关联,发热孕妇发生MSAF的风险高于未发热孕妇。具体而言,根据逻辑回归模型,发热孕妇发生MSAF的几率相比未发热孕妇增加了0.979倍(比值比[OR]=1.979,95%置信区间[CI]=1.061至3.693,P=0.032)。此外,感染新冠病毒的孕妇发生MSAF的风险显著更高,与未感染孕妇相比,几率增加了2.567倍(OR=3.567,95%CI=1.622至7.845,P=0.002)。此外,该研究还确定异常胎心监护(P<0.05)和孕周(P<0.05)是发生MSAF的独立危险因素。对于感染新冠病毒的孕妇,MSAF紊乱率显著增加,因此,有必要更加关注胎心变化和羊水情况,积极处理产程有利于改善分娩结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ab4/11573438/38b8c93c00df/CJIDMM2024-8456910.001.jpg

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